It’s an exchange familiar to anyone who keeps an ear open for government-level discussions on mental health: someone in opposition (often the MP for Liverpool Wavertree and former shadow minister for mental health, Luciana Berger) will challenge the PM on, for example, the barbaric way people are sometimes detained under the Mental Health Act, the dire lack of services that means those who have severe mental illnesses are being denied treatment or the shocking realities of half-year-long waiting lists.
Theresa May will, in response, reiterate her government’s "commitment" to making mental health a "priority", citing various Green and White Papers and the fact that they are paying for teachers to be trained in mental health first aid.
If this conversation were happening in equivalent parameters relating to physical health, Berger would say that people with stage four cancer were being denied chemotherapy, to which May would respond that they were training teachers to spot early signs of cancer in pupils. It’s not that the latter isn’t a worthwhile endeavour, simply that the conversation is happening at cross purposes.
Measures designed for prevention aren’t going to help people who are already severely ill.
This month began with our annual Time to Talk day, a campaign designed by magnificent charitable organisation Time to Change in which the public is invited to discuss mental health openly and without fear of judgement. Hot on its heels came Children’s Mental Health Week, commencing on 5 February. As I scoured the hashtags for both events on social media, I couldn’t help but reflect on the vast array of conditions and situations jostling for a finite amount of airtime. It’s for this exact reason that we don’t have a "physical health week" – the remit would be far too broad.
Talking about mental health is vital: it saves lives. And yet the benefits are impaired if we are all talking over one another about vastly different, incomparable points on an incredibly broad mental health spectrum.
I tend to separate mental health into three tiers: prevention, mental health first aid and professional support.
I dislike the term "prevention" because it suggests that looking after your psychological or emotional wellbeing is only relevant if there’s a chance you might go on to develop a mental illness. Just as most of us endeavour to eat well, exercise and look after our bodies, there should be an equivalent procedure for our minds.
It is no coincidence, for example, that mental health issues have skyrocketed as funding and curriculum time given to sport, art, music, dance and drama has been cut – particularly in the state sector. These subjects are known to have therapeutic value for pretty much everyone.
Mental health first aid
Mental health first aid is the art of being able to detect early symptoms of declining mental health, intervene appropriately and refer on for additional support where required.
It should be noted that what constitutes signs of mental or emotional distress in one person is just a facet of another person’s character (not wanting to spend time in crowds, for example), so this is where parents and teachers, who know children in context, can fulfil a valuable role. It would also encompass the mental health equivalents of administering plasters on knees or cups of Lemsip.
Once in the realms of mental illness, a parent or teacher could have been the most supremely qualified psychotherapist the world has ever seen, but to attempt to practice on a child they have an existing relationship with would constitute a conflict of interest.
No one can seem to agree on where the line between tiers two and three is, with some arguing, for example, that because so many children now self-harm it's unfeasible for them all to be referred on for medical support.
In practical, financial terms, this might be a fair assessment. However, the standard for which we should strive is that professional support is brought in at the point where parents, family or school staff indicate that the needs of the child in question have exceeded that which they have the skills or resources to meet.
In all of the tiers there are sub-categories. Depression and anxiety are both radically different from and related to bipolar and schizoaffective disorders, for example. Personality disorders are something else entirely, as are learning difficulties, and yet both are linked to mental illness.
By grouping all of this under the umbrella of "mental health", we allow the people in power to swerve scrutiny and insist that they are tackling problems which they are, in reality, actively exacerbating.
Children and adolescent mental health services (Camhs) have been slashed dramatically since 2010. Whilst the government has promised "mental health support teams" for schools, it was revealed last week, following Nick Gibb’s baffling contribution to the Commons Education Select Committee’s session on mental health, that it has no idea where these professionals are going to come from and that they will in all likelihood constitute a combination of psychology graduates and existing school mentors.
Most devastatingly, by talking about "mental health" as though it is one, unified entity, we allow the government to place more and more responsibility on school staff to take on roles which can only be undertaken effectively by qualified counsellors, therapists, Camhs workers and other professionals.
Next time you hear someone say "one in three people has mental health" remind them that we all have a head with a brain and, therefore, a mental health.
One in three people will experience symptoms of a mental illness and that’s a different statement altogether. We all need to give some consideration to monitoring and maintaining our mental health, and embedding wellbeing initiatives that benefit pupils and teachers alike is a great way to encourage this.
Existing in an environment that encourages mental wellbeing can also not only prevent mental illness from manifesting to begin with, but it can also improve the efficacy of professional support. However, these types of projects cannot ever take you beyond tier two.
For those people who have the severe mental illnesses, shifting the focus entirely to prevention allows them to languish indefinitely, whilst the government continues to give the illusion of action through pretty-sounding but meaningless rhetoric.
Natasha Devon MBE is the former government mental health champion. She is a writer and campaigner and visits an average of three schools per week all over the UK. She tweets @_natashadevon. Find out more about her work here and preorder Natasha's book A Beginner's Guide to Being Mental: an A-Z here.
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