It is World Mental Health Day today. As a counsellor - and wellness coach - I should be pleased about this, but instead I am frustrated. I see the caravan of soundbites and quick fixes rolling forward, gaining momentum - but there is still little evidence that anyone is really listening, or that attention is being paid to what really matters.
Terminology is part of the problem. The words “mental health” and “mental illness” put medical tags on different and widely varying psychological experiences which are very difficult to quantify in scientific terms, however many questionnaires we may now have, to assess a person's mental state. We are dealing with human beings in all their wonderful complexity and with all their individual experiences and needs. Rather than using medical terminology, I prefer to talk about psychological distress or emotional “dis-ease”.
This then prompts a searching question - where has this person's distress or “dis-ease” come from. What has caused it? In essence we should not be asking the suffering person what is wrong with them; it is all about what has happened to them. What survival mechanisms have they needed to employ and why? The answers to that question could encompass recent events, or adverse childhood experiences from long ago; they could involve one-off tragedy or long-term, low-level trauma. The person is, in fact, reacting normally to abnormal circumstances. Sometimes, multiple factors have collided catastrophically - and if the individual had not been adversely affected, there really would be something wrong.
Strong personal relationships can buffer us against the worst that life throws at us, but in many cases those vital connections are not there, or are insufficient. The most important thing any of us can do is really hear what has happened, and ask “what are you living with now, that has knocked you off balance?”. It is not about a blame game, but about what it means fundamentally to be human in the widest sense.
We need to listen to each person's story, in their own words and in their own time; we need to offer a place of safety, where we are prepared to sit with their distress; we need to build a relationship of trust and acceptance, really valuing the individual; and then walk alongside that person as they find a new way forward. Yes, as professionals we can give insights, offer observations and use techniques to help develop their narrative when words alone are insufficient or impossible* - but it is the reliable and responsive relationship which matters the most. It takes time and commitment. Both are in short supply in the modern world, but it is only that which will help to fill the void and heal the hurt which is so endemic in our society.
And that brings me to the really challenging part. If how we are living - and how we treat each other - is now causing so much emotional distress and mental “dis-ease”, what are we going to do about it? We need to take a long hard look beyond the individual - at family life, at community, at education, at employment practices, at social services, at disadvantage, at discrimination... the list goes on. The solutions needed are radical, long-term and expensive - and stretch far beyond “mental health” hashtags.
* The photograph illustrates a sand tray exercise - a useful form of expression when words are hard to find.