On the road to reframing the narrative on mental health following the COVID-19 outbreak
When I started writing this, it was mental health awareness week. Having worked in mental health for over fifteen years (in both clinical and academic settings), over the last two years I have started to notice a shift in the narratives around mental health, especially following the COVID-19 outbreak.
A trip down memory lane
Following the de-institutionalization of mental health in the 1960’s (where mental health care transitioned from asylums to community services), the narrative around mental health has been one of fear and division. During my psychology undergraduate years, I clearly remember being examined on the prevalence of mental illnesses — some of the figures still echo in my head — one in four people will experience a common mental health problem, such as depression or anxiety. However, the underlying tone I heard was that mental health problems will not affect everyone.
Furthermore, the image of patients acting dangerously or in a violent manner as a result of their mental health has created a stigma that has been especially hard to shake. Although we know that some mental health symptoms are associated with an increased risk for violence, what we also now know is that mental health patients are significantly more likely to experience victimisation (victimisation is defined by the World Health Organisation as any person against who violence is used). There is evidence to support both- that an experience of victimisation can lead to worsening of mental health, but also that having mental health problems can increase the risk for experiencing victimisation.
Furthermore, looking at the literature on mental illness recovery and remission, although we have quite clear guides on what they look like in relation to medication prescribing, when we think about the person’s everyday functioning, recovery and remission have remained rather illusive.
As someone who conducts research using anonymised electronic health records, I know first-hand that it is much easier to determine what medication someone is taking than their level of functioning and wellbeing at a given point in time. The latter would require a combination of subjective and objective measures of personal experience. This raises some important questions about how we see and discuss mental health wellbeing in clinical settings as well as in our everyday lives.
Change is coming
As we begin to see glimpses of post-COVID-19 life, we are now beginning to emerge from something, which has been termed ‘collective trauma’. The definition of collective trauma is a psychological reaction to a traumatic event shared by a group of people. The harsh consequences of COVID-19, bereavement, social isolation, shielding, stress due to change in circumstances just to name a few, are emerging rapidly, with rates of depression, anxiety and other mental health problems expected to hit a record high as the year unfolds alongside the relaxation of lockdown measures. We are finding ourselves in uncharted territory, on a global level where almost all of us have been affected psychologically by the pandemic.
This collective experience has precipitated a shift in how we talk about mental health. Mental health problems are no longer seen as something only few would experience in their lifetime. As we open up to share our experiences of the pandemic so has the conversation about mental health. Social media has provided a platform where people can share their experiences and how these have affected their mental health.
A further poignant moment for me has been the shift in public perception and talking about having a mental health problem as a yes or no narrative, to talking about our mental health as having good and bad days.
Furthermore, we have begun to shift our view of recovery from a destination that only few will reach, to a journey that we all go on — some parts of this road are freshly paved and easy to walk, others are full of potholes. Ultimately, what each and every one of us needs is to develop tools and strategies for whatever the road brings.
The journey ahead
I have really enjoyed reading the Metro edit on mental health awareness week and it is so refreshing to see such a diverse coverage of mental health on scale. One message that particularly stuck with me was about the need to keep the conversation going so we can turn this momentum into action. There are several initiatives, which I believe are instrumental to achieve this. For example, I am especially excited to hear mental health being spoken about in schools, with campaigns from charities such as Mentally Healthy Schools by the Anna Freud National Centre for Children and Families, which aim to promote mental health and wellbeing. A number of children’s charities have also developed resources and toolkits for mindfulness, breathing and relaxation.
We need to educate the young generation on the value of maintaining good mental health and equip them with practical tools and strategies for how to do this.
Leveling up mental health care on par with physical health is essential, just like taking our daily supplements, eating a healthy diet and exercising, we all need to be talking about having strategies and tools to maintain good mental health.
Collectively we all play a part in changing this narrative. Let’s keep the conversation going.