TW: in depth discussion of mental health issues, mention of mental health crises
Every World Mental Health Day, we are told to ‘check up on our mates’, that it’s ‘okay not to be okay’, that we must ‘reduce stigma’. All of this is true, and fifteen years ago would have been revolutionary. Until this century, really, no-one was talking about mental health, so the fact people are openly speaking about it now can only be a good thing. An open societal conversation helps people facing mental health issues both feel less alone and more able to seek the support they need, and dismantles the idea that mental health problems are unimportant, secondary to physical health problems, or the domain of ‘snowflakey’ young people. But now, after years of activism centred around raising awareness in perhaps too shallow a way, the underfunding of mental health services across the UK is becoming a bit of an elephant in the room.
NHS mental health services have gone years without appropriate funding to match the vast increase in demand, leaving many waiting far too long for treatment they desperately need. The government’s own independent Mental Health Taskforce flagged up severe underfunding back in 2017, and while 23% of NHS activity is occupied by mental health, the sector receives far less funding than is needed. The system is also disproportionately failing people from marginalised groups; an NHS report from 2020 details how Black patients are far more likely not to receive care at an early stage of treatment than white patients, and are far more likely than white patients to have been detained under the Mental Health act.
It’s come to the point where many patients resort to using mental health crisis services or going to Accident and Emergency because long waiting times mean they are going months without support. The over-emphasis on these crisis services is perhaps a symptom of the fact our mental health services are not working as they should. Much was made of Prince William volunteering for SHOUT, a text-based crisis helpline, back in June; newspaper articles on the topic of mental health usually supply the Samaritans’ phone number at the end of the main piece, but do not mention the prospect of going to your GP if you’re suffering from a mental health problem.
Crisis helplines are crucial, and necessary, but we need to be helping people before they get to that point, and there simply isn’t the funding. The theme for Mental Health Awareness Week 2021 is ‘nature and the environment’, and the theme for last year was ‘kindness’ – with so many not receiving the support they need from the state, why are we not asking for more?
A lot of people suffering from mental health problems find mainstream activism patronising and inadequate. Some even think the slogan ‘it’s okay not to be okay’ is actively harmful, reducing complex and severe mental health problems to being ‘not okay’ and perhaps even normalising going months or years without proper help. It glosses over the mental health conditions and symptoms which we actually don’t talk about, the ones that appear less ‘palatable’ to mainstream media, like psychosis, personality disorders, and obsessive compulsive disorder. Repeating ‘it’s okay not to be okay’ does nothing to help those suffering from mental health problems; we know that it’s okay. Feeling less alone can be nice, but ultimately isn’t going to solve anything long-term and is no substitute for proper treatment.
I’m also concerned that the ‘check in on your mates’ messaging, while well-intended and important, perhaps shifts responsibility away from those to whom it should really fall. This year the mental health charity ‘Time to Change’ launched their ‘Ask Twice’ campaign, which revolves around asking your friends how they are a second time, in order to maybe receive a different, more truthful answer. Friends and peers can be incredibly important in helping people take the first steps towards receiving help, and their support is vital for those recovering from mental health issues. And ‘Time to Change’ focused especially on male mental health in their campaign, which is laudable as often men are less likely to feel like they can speak about mental health problems. But conversations like these with our friends really are just the first step, and the ongoing support of friends should always be underpinned by professional treatment. It’s just like how, often, crisis helplines are promoted over seeking professional medical help; the emphasis is on short-term solutions instead of addressing the long-term problem. We’re focusing far too much on these first steps and not on the chronically underfunded follow-through. By acting like ‘talking about it’ or ‘checking in on friends’ is a cure-all, we absolve the government of responsibility to tackle the underfunding it has presided over for so long.
Student mental health at Oxford is affected by similar issues. While the university does have its own free counselling service, it’s clear this is intended either for people who want to talk through a short-term, tangible problem, or as a stop-gap for people with longer-term mental health problems before they receive professional medical treatment. Students are most frequently only offered six counselling sessions as a maximum. Yet this often isn’t enough to carry a student over until they can receive NHS treatment – waiting times are far longer than they should be, and waits for eating disorder services can exceed twenty-one months in Oxfordshire. Colleges also often actively uphold policies which negatively affect student welfare, such as banning suspended students from entering college, or forcing students with severe mental health problems to move out of college accommodation. Change in Oxford colleges is slow at the best of times, leaving the JCR Presidents and Welfare Officers who are trying to initiate positive change demoralised and exhausted. The university also seems to be taking the approach that short-term solutions are enough. But when it comes to student welfare and mental health, improvement only happens when we invest time and money into positive change.
This isn’t intended to write off all of these campaigns or initiatives as wholly negative. The public perception of mental health problems would not have improved so quickly without them. But fundamentally, activism shouldn’t just be focused on improving what people think of us. It should be about helping us, which means on a national scale addressing the glaring issues that this government and many governments of the past have wilfully ignored, and at the university, listening to students and SU officers and actively upending harmful and archaic policies. Helping us doesn’t just need talk, it needs money; it needs society not just to view mental health problems as normal, and valid, but also as worthy of funding and concrete support. There has been enough talking – we need action.