Awareness isn’t working

We’ve spent the last decade talking non-stop about mental health, yet every statistic is moving in the wrong direction.

We’ve spent the last decade being inundated with mental health awareness days. 

• World Mental Health Day - October 10

• Children's Mental Health Week - February 5 - 11

• University Mental Health Day - 14 March

• Mental Health Awareness Week - May 13 - 19

• Men's Mental Health Awareness Month - November

• Time to Talk Day - February 1 

And that’s just the tip of the iceberg. 

Social media users love these awareness days. 

And like clockwork, every time we hear the same mantras again, and again, and again: but these slogans are misleading at their best, dangerous at their worst. 

“Just reach out! Help is out there! Just message me and I will be there!”

Help isn’t as available as these platitudes make it seem. Even if you can muster the enormous amount of strength to ‘just reach out’, you’ll find that there actually isn’t a whole lot of help out there. 

More than 1.8 million people are already waiting for mental health support from the NHS. Support is stretched thin. It isn’t fair to make out that it is easily accessible. 

And I so often see strangers online who will insist: “please message me, I will always be there, my DMs are open” - but that stranger is probably not equipped to deal with someone having a psychotic episode. 

“It’s OK to not be OK!”

Mental health isn’t as destigmatised as campaigners would like to believe. 

Sure, there’s less stigma now than there was ten years ago - but that acceptance has been most concentrated on very palatable mental health disorders (like depression and anxiety), and the most non-disruptive symptoms. 

“Mental health is just like physical health! It’s just like a broken arm!”

There are, perhaps, some merits to the idea of treating mental health like physical health. But there are also some major flaws in the metaphor. 

Hannah Jane Parkinson put this most articulately in her rightly acclaimed Guardian article, ‘It’s Nothing Like a Broken Leg’: “I have never broken my leg. Maybe having a broken leg does cause you to lash out at friends, undergo a sudden, terrifying shift in politics and personality, or lead to time slipping away like a Dali clock.”

And beyond that, this analogy perpetuates the idea that mental illness can be fixed with a magic pill or special therapy session. But mental illness is generally much harder to treat than any physical ailment. You can’t rest away depression like you can a cold; you can’t put psychosis in a cast and leave it to heal. 

It often requires work and effort from the sufferer in a way that physical ailments do not.

“One in four of us will develop a mental illness”

Any statistic that you see about how many people will get a mental illness is almost certainly made up. There has never been conclusive, medical or scientific research into the prevalence of mental illness.

We are, right now, continually reinventing the meaning of mentally ill. We’re in danger of perpetuating the idea that any negative emotion is a medical anomaly that should be blasted immediately; and turning mental health diagnoses tools into pseudo-personality tests.

That’s not helpful to anyone. People who might be feeling down because of their situation (like an unhappy relationship, or a toxic workplace) are encouraged to treat their symptoms, not change their situation. 

People experiencing moderate mental distress are told there’s something wrong with them, and they’re encouraged to join the long queue for professional support. This leaves them feeling hopeless and helpless until they get a therapist - when they could be getting better with the right self-guided interventions. 

TikTok teenagers are diagnosing one another with sometimes severe and complex mental disorders, when typically what they are experiencing sits on the spectrum of normal emotion. Social media rewards the most relatable content, so these online influencers are incentivised to ‘diagnose’ as broadly as they can. The risk here is that young adults internalise a diagnosis they don’t necessarily have. For example, if someone becomes convinced that the normal, everyday nerves or stress they have is clinical anxiety, then they’ll start to avoid stressful situations: and reducing exposure to these normal stressors of life only serves to deepen anxiety to the point it truly does become inhibiting. 

All emotions, in reality, sit on an incredibly long spectrum. Turning negative, but normal, emotions into signs of dysfunction and constantly seeking to diagnose each other with illnesses is not a good thing. 

What’s the alternative?

I know that all of these campaigns, catchphrases and awareness days are well-meaning. The social media influencers just want to help. And in some ways, they do have powerful and important messages. If you are struggling, you absolutely should seek help. You should not feel stigma. You deserve to be supported. 

The trouble is that something isn’t working. Mental illness, suicide and self-harm have all risen in the last ten years, as these awareness days have gone off the charts. 

I think it’s fair to say I spend more time than most thinking about these things. And I think there’s a fundamental flaw in how we think about mental health. We’re obsessed with diagnoses. We’re obsessed with cures. We are laser focused on mental illness, and spend almost no time thinking about mental wellness. 

The only time someone will ever be taught how to handle their emotions is when they get into therapy. But that’s like teaching people how to drive when they're halfway round the M25. 

We teach people how to drive before they get on the road. Given these emotional skills are so essential, why don’t we teach them in schools, before they’re needed? 

What might an ambitious and effective mental health curriculum look like?

First, it would focus on arming young people with the tools that we know improve mental health. Some of that will come from therapies like Cognitive Behavioural Therapy (CBT). It could be teaching young people how they identify negative automatic thoughts, or how they challenge faulty thinking. 

It’s also about helping them to develop healthy coping mechanisms, and empowering them to face up to stressors: because we know that successfully dealing with a small amount of stress in early life is the closest thing we have to a vaccine against mental illness in later life.

Second, this curriculum would nurture help-seeking behaviour. Many mental health campaigns over the years have focused on ‘reducing the stigma’ of talking about your feelings, but very few answer the question of “who should I be talking to?”. Young people should be taught the practical components: what help is realistically available, when is the right time to seek it, and how to access it. 

Nobody wants these lessons to be taught in hospitals after it’s too late, or by amateurs on TikTok. 

The solution, or at least part of it, is to teach mental coping skills before they are needed. Reducing mental health waiting times and freeing up hospital beds; ensuring people are happy and healthy, contributing to society and their communities; cutting down prescriptions for antidepressants; and ultimately reducing mental illness, suicide and self-harm in the next generation.