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.

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Politics

12 January 2024

5 min read

Why we need a gentle radical revolution

Our social arrangement needs to prioritise human relationships, argues MP Danny Kruger.

Danny Kruger

Danny Kruger is the Conservative MP for Devizes. He is the author of Covenant: The New Politics of Home, Neighbourhood and Nation.

A group of people stand in a field by a fence and a railway footcrossing.

Danny Kruger with a campaign group in his Devizes constituency.

Democracy divides us. The political system best calculated to hold together a diverse society is also one that exacerbates differences and obscures our common opinions and interests. A two-party system - and all Western politics is largely binary, split between conservative and progressive parties or groups of parties - encourages vicious disagreement across the aisle, and polarises opinion in the country.

The paradox is that, despite our party disagreements, the most popular opinion with the public is that ‘they're as bad as each other’. The view held in common across the country is that ‘they’re all the same’; that ‘there’s nothing to choose between them’. And deep down, the public is right, but in a good way. Fundamentally the parties share a worldview, which derives from our common inheritance as the heirs of the Christian tradition.

That tradition taught us that individuals are intrinsically, personally, valuable, without reference to the identities of sex, household, tribe or race which, in pagan cultures, gave people their only worth (or for most people, their lack of it). It also taught us that, despite our individual personal value, our mission in life was other-facing. Our object of worship was outside the self. God’s will was made material and meaningful through the institutions of our common life, in what we came to call civil society. These institutions in turn, especially the institution of the law, worked to protect the individual and make diversity safe.

This tradition split into two parts in the modern age, as an old, anti-Christian idea, which Christianity had expunged, crept back in. In my book Covenant I call it ‘the Idea’, as opposed to what I call ‘the Order’. The ‘Idea’ is that I am god, with the creative power to order reality and decide for myself what is right and wrong. This ancient heresy has been refreshed in our times precisely by the principle of individual rights and freedoms that Christianity gave us. This is because we have steadily degraded the other side of the Christian bequest: the other-facing, institutional life that gave individuals a more textured sense of who they were, i.e. members of a community with something to live for outside themselves. The consequence is both the narcissism of self-worship and the rise of identity culture - a return to the pagan belief that your value is determined by your sex, race or tribe.

In the age of tech we can create a decentralised, responsive and personalised system that will give us both belonging and agency.

Individual value and dignity, made safe and meaningful by a social arrangement which emphasises solidarity, peace and care for the stranger - these are the elements of what I call the ‘Order’. They are not absolute principles: even individual rights to life and liberty must be constrained in certain circumstances, and other-facing generosity likewise needs to be limited in order to be sustained. To take a current example, ‘care for the stranger’ does not, in my view, mean offering a home in the UK to anyone who manages to arrive on our shores and claim asylum. It does mean treating every asylum seeker humanely, whether we admit them or remove them, and it means committing part of our wealth and power to preventing, or mitigating the effects of, war and natural disaster in other parts of the world.

How does such a covenantal politics approach other policy areas? The principles that Graham Tomlin set out in the report he compiled after the Grenfell Tower fire, after listening to local voices, are a helpful guide. We need to ‘humanise welfare’, dismantling the inefficient bureaucracies which see people as units to be managed, rather than as people to be helped and given responsibility and agency, and build instead relational systems of social support. We need to ‘provide homes’, which means so much more than the sterile term ‘housing’: it means attractive, affordable, safe buildings where people can live both with privacy and in community. As this suggests we need to help people ‘become neighbours’, with the means and the motivation to connect with others who belong to different identity groups. We should ‘notice faith’: as happened after Grenfell, it is local community faith groups which more than any official agency provide support, belonging, cohesion, and practical change at a local level.

And lastly, overall, we need to ‘renew democracy’. In Graham’s words, ‘we need to find ways to enable people, especially in more deprived areas, to have more of a say in issues that directly affect their lives, rather than politics happening at a distance by competing parties remote from local life.’ The sense of this is both deeply conservative (small-c) and deeply radical. Of course, we need power to be close to the people; this was the traditional way of things before the Durkheim and his followers decided that the centralised state, not local civil institutions, was the proper place for managing human services. In the Middle Ages, according to Robert Tombs’ history of England, fully a third of men, of all classes, played a responsible role of some kind in the management of their neighbourhood. Yet a return to this model would be radical, because it involves upending Durkheim’s assumptions - shared by his heirs in the school of New Public Management beloved of the Blairites - about the proper arrangement of society.

We need a gentle revolution: a return to some old ideas about social organisation that prioritise human relationships, the organic and the natural over utility, efficiency and equality of outcome; ideas which actually lead to a more useful, more efficient and genuinely more equal system. These are the ideas of what I call the Order, derived from theories of the social covenant that lie deep in our history but which are also best fitted to the modern world.

In the age of tech we can create a decentralised, responsive and personalised system that will give us both belonging and agency. We can recreate a more localised economy, but this time more fair, equal and capable of supporting a larger and more diverse population than the pre-modern world knew. And we can make a democracy that more closely reflects the principle that we all, whether progressive or conservative, share a common inheritance and belong to a single political community.

Covenant: The New Politics of Home, Neighbourhood and Nation is published by Forum Press.