I was recently interviewed by Bridget Minamore for a piece in The Debrief on young men and mental health.
You can read the full article here, and here are my answers to Bridget’s questions about mental healthcare and people being open about their struggles.
What are some of the biggest barriers to people accessing good mental health care?
One major barrier is financial. While there is some good mental health care provided on the NHS, and by voluntary agencies, if you have less money or no money then it is much more difficult to ensure that you see a practitioner who is a good fit for you, and you may well be limited to a certain number of sessions. Wealthier people have a much greater range of private options available to them, and can shop around to find somebody they have a good relationship with: which is the most important factor predicting success in therapy.
After that I would say the stigma around mental health is still a massive barrier. People can be scared to acknowledge any struggles to themselves and others. For many groups it goes beyond an issue of stigma and shame, to being actually dangerous to admit to mental health difficulties, for example in terms of risk of losing work or having control over treatment taken out of their hands. Again it is generally the most marginalised groups in terms of class, race, disability, etc. for whom this is most risky.
What sort of practical support do men and young people with mental health issues need?
For men a major barrier are the cultural expectations around masculinity which can make it very hard to speak openly about emotions or admit to having problems. Until we have some major cultural shifts in how we understand gender, this means that it can be good to offer support tailored specifically to men, perhaps in ways that fit masculinity better than conventional therapy. For example, peer support which takes place in sport or pub settings can feel a better fit for some men.
In addition to being protected from poverty, discrimination, abuse, neglect, and violence (key causes of mental health problems), young people drastically need better personal and social education in schools to help them to learn about how to handle difficult feelings and develop relationship skills. These kinds of preventative measures would be far better than treating young people after they’ve developed mental health difficulties. However, of course, until the world has changed we definitely need good online and offline support for young people to go when they’re struggling.
Do you think it’s a positive that people in the public eye are speaking more about mental health issues? Why?
I think it can be very helpful indeed in decreasing the stigma around mental health, and letting people know that it is okay to struggle. However, unfortunately, people in the public eye often tend to tell very particular stories around their mental health issues: often stories where the issues are seen as purely biologically caused, and stories where they ‘got better’. It’s important to recognise that many mental health difficulties are caused by social problems, such as the ones I’ve already mentioned, and that many people do not have the resources that celebs have to get help and support.
What are the problems in the NHS at the moment re mental health care? What solutions are needed?
The main problems would be those facing the whole NHS at the moment of being hugely under-resourced and under-staffed. We need far greater investment in the NHS to enable it to support all those with mental and/or physical health needs, and we need to become a more welcoming country to immigrants, many of whom have just the expertise that we need.
Are you worried about the fate of the NHS with regards to mental health care? Why?
Very worried given the current lack of investment in the NHS. It’s just one more area where we see a widening gap between the rich (who can afford private therapy and other healthcare) and the poor (who can’t). Often those with less money will end up getting 6 sessions of CBT, maybe online rather than in person. This can be helpful, but it doesn’t work for everyone, and it can even be counter-productive for somebody whose distress has very real social causes to locate their suffering in individual ‘negative automatic thoughts’, for example. If we want to tackle mental health problems we need a more equal society.
End of story.
For more on the social side of mental health struggles, check out:
My zine on Social Mindfulness
My other blog posts on mental health include:
- Mental health beyond binaries
- Mental health: Beyond the 1 in 4
- Mental health: Beyond a health focus
- Mental health interview 1
- Supporting each other through mental health crises
- Mental health and relationships