Article

Comment

Mental Health

1 February 2024

4 min read

We need to weep over the wreckage of mental illness

While its now OK to talk about mental illnesses, we need to weep over the harm caused and how we’ve tried to treat them, writes Rachael Newham.

Rachael Newham

Rachael is an author and theology of mental health specialist.

A grey and white wall graffited with a tag a image of a person crumpled and crying.

Today, February 1st, is Time to Talk Day. It's part of a long-running campaign encouraging people to have open and honest conversations about mental health. It's aim is to break down the barriers of stigma and misunderstanding. It has been a staggering success - what was a fringe issue talked by those only affected by mental illness a decade ago is now part of common parlance. Mental health training is widely available, and the charity’s work has been seen to have a significant positive impact on the mental health conversation

However, as our familiarity with the language of mental health has grown so too has the way we use it. People might talk about having PTSD after a bad date, or their friend being ‘so OCD’ about the way they organise. Unwittingly, as psychotherapist and author Julia Samuels points out, “[we have] awareness without real understanding.”

However, awareness without understanding means we actually don’t reach those most impacted by mental illness. We know about mental health in the way we know about our physical health - but we are no more aware about the serious, sometimes lifelong mental illnesses which rob people of hope, joy and vitality - sometimes leaving them with lifelong disability.

If you ask most people about mental illness they may tell you about depression and anxiety; the two most common mental illnesses which have become the acceptable face of mental illness. It’s reflected in the way funding is channeled to interventions that get people with mental illnesses back to work, or to NHS ‘Talking Therapies’ which offers short term psychological therapies (both of which are important initiatives) but have cut the number of inpatient beds from over 50,000 in 2001 to under 25,000 in 2022[3] which means those at the more severe end of the spectrum of mental health to mental illness are left to travel 300 miles for the care they need.

We have to survey the wreckage that severe and enduring mental illness causes, before we can begin to rebuild a society that is kinder - without prejudice or stigma.

Whilst it’s right that we have raised awareness about the most common conditions, we can’t ignore the illnesses which are termed ‘severe and enduring mental illnesses’ which include those such as bipolar disorder, major depression, schizophrenia and complex post-traumatic stress disorder.

For people living with these conditions, the general mental health advice that we give; for example getting enough sleep and time outdoors may not be enough to keep the symptoms at bay. Just as general physical health advice like getting your five a day will not cure or prevent all severe physical illnesses. Medication, hospitalisation, and at times even restrictions of freedom like being detained under the mental health act might be necessary to save lives.

These are stories that we need to hear. The debilitating side effects of life saving medications that can raise blood pressure, cause speech impediments. The injustices to confront (such as the fact that black people are five times more likely to be detained under the mental health act than their white counterparts) and the adjustments to life that those with disabilities are required to make to their lives.

We have to survey the wreckage that severe and enduring mental illness causes, before we can begin to rebuild a society that is kinder - without prejudice or stigma. We have to listen to the perhaps devastating, perhaps uncomfortable stories of those who live with severe and enduring mental illness. The mental health npatient units miles from home, the lack of freedom, the searing - unending grief.

Weep for the lives lost, the crumbling systems, the harm caused both by mental illness and the way we’ve tried to treat them.

By hearing these stories, we are accepting them as a part of reality. For those of us in churches it might be that the healing didn’t come in the way we expected, it might be also be all of us accepting that the systems designed to care for those with mental illness have in fact, caused more harm. It’s seeing the injustices and understanding that we, our systems and professionals need to change our attitudes.

Understanding and acceptance of the injustice are the way forward- that’s the only way change can come.

It might look like standing in the rubble, it might feel too huge and all but hopeless.

And yet in scripture and in life that is so often the only way we can begin to rebuild.

In the book of Nehemiah, one of the Old Testament prophets who had lived in exile far away from home for his whole life, we see that upon hearing about the state of the walls of Jerusalem, before he did any of the things we expect heroes and innovators to do- he wept. In fact, it’s estimated that for four months he wept over the state of the place that had once been the envy of the ancient world.

Perhaps we too need hear the stories and then weep.

Weep for the lives lost, the crumbling systems, the harm caused both by mental illness and the way we’ve tried to treat them and then slowly, we can begin the work of rebuilding.

It isn’t a work that can be done alone by a single agency much less a single person - it requires society to hear stories of the more than just ‘palatable’ mental illnesses with neat and tidy endings to the messy and sometimes traumatic stories that are there if we just care to listen to them. It might be reflected in the petitions we sign, the way we vote, the stories we choose to read.

So ,this Time to Talk Day - I’m saying let’s continue the amazing work of talking about mental health - we need to keep talking about anxiety and depression. But let us also make conversations wider, so that they encompass the whole continuum of mental health and illness.

We’ve seen the difference Time to Talk can make - now it’s time to talk about severe and enduring mental illnesses, too.

Article

Comment

General Election 24

Politics

20 June 2024

4 min read

What small boats tell us about belonging

Do I belong to these politics? And do these politics belong to me?

George Pitcher

George is a visiting fellow at the London School of Economics and an Anglican priest.

A grainy surveillance picture of an rusty boat overloaded with people

A small boat overloaded with migrants.

BBC.

Our son used to say that “home is where the dogs are”, as he was greeted by them. It’s a variation on “home is where the heart is”. Either way, it means that a sense of home isn’t just about place or geography, so much as family and, relatedly, the familiar.

If home were simply an address, candidates in an election campaign wouldn’t bother knocking on doors to meet people. To be familiar is to meet people where they are, circumstantially as well as literally on their doorstep.

To date, the solution to the refugee crisis has been to “stop the boats”, as if our principal concern is with rubber dinghies. We’ve still not addressed the people in those boats; we’re not familiar with them, their circumstances and motivations.

I’d hazard a guess that a common desire among those who flee persecution and mortal danger is something else associated with familiarity – a sense of belonging.

The refugee belongs nowhere, until she or he reaches a new and safe home. Indeed, all of us know we’re home only when we’re somewhere we belong.

Somewheres are rooted in place and community; Anywheres are footloose and and educationally privileged. To which I would add the global category of migrants, who are Nowheres.

This is Refugee Week (17-23 June) and Thursday 20 June is World Refugee Day. It’s theme this year is “Our Home”, which is why I started this column on the nature of familiarity and belonging.

Out of which arise two questions: Do I belong to this country? And does this country belong to me? The first is fairly straightforward in a practical sense – I have a British passport and pay my taxes here, so yes I do. The second question is more complex, more of which in a moment.

When it comes to sovereign governments, the questions move from first to third person. Do you belong to (or in) this country and does this country belong to you? Again, the first question is about paperwork. The second, however, becomes crucially about exclusivity.

Exclusive ownership reaches its abhorrent nadir in a BBC2 documentary this week titled Dead Calm: Killing in the Med?, which provides evidence that the Greek coastguard has been employing masked vigilantes to cast adrift landed refugees, including women and children, in international waters and, in some cases, to throw migrants overboard to their deaths. A story told alongside the capsizing, through incompetence or otherwise, of the rust-tub Adriana, in which more than 600 migrants drowned a year ago.

These are matters for international law. But it shows where treating migrants like cargo, rather than people, takes us. It’s a mindset that could start with repellent (in both senses) wave machines, as considered by a former UK home secretary.

None of which arises if the criteria of belonging are applied. Former Prospect editor David Goodhart famously wrote that a key electoral demographic could be defined in Somewheres and Anywheres. Somewheres are rooted in place and community; Anywheres are footloose and and educationally privileged. To which I would add the global category of migrants, who are Nowheres (see above).

The key here is having nowhere to belong. Former PM Theresa May talked of “citizens of nowhere” in 2016, but she meant globe-trotting tax-exiles and the like. I mean Nowhere people, with nowhere to go – and it’s toxic for all of us that there are so many of them.

This is where the question “does this country belong to me?” carries so much human freight (like a small boat, as it happens).

To belong is an atavistic human need. American psychologist Abraham Maslow’s hierarchy of needs places belonging and love as principal needs in his pyramid between basic physicalities (such as safety) and self-fulfilment at the apex. “Belongingness”, a sense of home, is vital for human stability.

This is where the question “does this country belong to me?” carries so much human freight (like a small boat, as it happens). Simply to repel refugees like they’re someone else’s problem is massively to miss a point, because they’re going to carry on looking for somewhere to belong. So they’re going to keep coming.

Maslow identified religious groups as one of those offering a sense of belonging. I would guess as much as two-thirds of the congregation I’ve looked after over the past decade came to church for that sense of belonging, which we’re called to offer to the despised and marginalised as well as the Somewheres and Anywheres.

Miroslav Volf has written here that “God created the world to live in it” and therefore, I contend, belongs to it. So we’re called to “live in more homelike ways”, which I define as a sense of familiarity and belonging. That’s the theology of it.

We are now facing the politics of it. Nationalism is not enough. We need leaders who can solve this at a global level, which is both a political and a theological imperative.

Perhaps a way of reframing my questions, in this Refugee Week as we ponder how to vote, is: “Do I belong to these politics? And do these politics belong to me?”