Are we stigmatising ordinary human emotions.
This week Clare Hanbury and I decided to chat about youth and mental well-being. Our views tend to be quite different than the norm, which is perhaps dues to our unique experiences. I do feel that there needs to be better and more nunaced conversations about mental well-being and I really do struggle with the way the current system approaches such issues. Would love to hear your thoughts on this important issue.
I want people to ‘BE happy’. I want people to ‘HAVE well-being.’ I’m sure you do too!
I am a health educator and I love finding practical ways in which children themselves can develop their skills to help protect and promote all aspects of their ‘health’. I have often argued for that the kind of holistic approach to health, so of course I’m interested in the new-ish kid on the block – ‘mental health’.
But I’m struggling. I’m struggling to decode ‘mental health’ (isn’t it mental illness?). I’m not at all sure it’s even possible to make someone happy or even to promote their well-being– this is rather up to them. But, I’m a practical sort so if I don’t think it’s possible, it has got me thinking about why I’m so ‘off trend’ with this and isn’t there something that an organisation like CfH can do and promote in this field?
I find I am in good company. On a podcast recently, the noble laureate psychologist Daniel Kahneman was explaining how impossible it is to ‘make someone happy’ and that our best bet is to focus instead on ‘preventing misery’ – so help create conditions in which happiness and well-being thrive and try to figure out the obstacles there are to getting in the way of well-being and happiness.
Maybe I even question that all this happiness and well-being is in fact the end goal that we want. For most of us, isn’t life a long series of problems that we just have to deal with? That we are often knocked down by and have to get up from? Could it be that by focussing on mental health and well-being we are setting a ridiculously high bar and making people more unhappy? Or worse – is it pathologising and giving a name to a human condition that some might unnecessarily then seek professional help to ‘fix’ – identifying as ‘ill’ vs normal? Don’t we want instead to be resilient, to build our resilience and help others do this too? Resilience is a term that I first encountered in the early 1990s in my work with children who lived on the street whilst exploring how many children manage to cope and even thrive while living in extraordinarily difficult circumstances.
Let me quickly and strongly make a distinction between mental illness and mental health. I am not qualified to address the complexity of mental illness. I know it’s a crucially under-recognised, underfunded, poorly treated and stigmatised health area.
Some great work is happening in schools and with young people to help support those with mental illness and address stigma. I particularly like the work of Stan Kutcher and his team at Teen Mental Healthand their ground-breaking work in Malawi. Exploratory work with this team suggested that what I think Children for Health should focus on is not ‘mental illness’ but the day-to-day issue of understanding and building resilience.
So, when I reflect on mental health and well-being…
I see in my mind’s eye the strong and articulate group of Somali children I’ve spent time with, stuck in a refugee camp in a moonscape of a place in Yemen and forming a health and life skills club to promote health among their friends and family.
I see the 14,000 unaccompanied Sudanese minors I met (yes really – I addressed them with a megaphone) living in the huge Kakuma refugee camp in Northern Kenya, planning together how they can better care for the younger ones in their midst and seeking out sport, song and dance to lift their mood and build connections.
I see the group of street kids I met who lived in the middle of Addis Ababa who were praised by the Red Cross for their remarkable help to a community whose houses were burned down in a fire.
I see orphans from the Rwandan genocide – involving themselves and their friends in a campaign to rid their community of cholera and in so doing recovering from PTSD and regaining their energy and voices to do other things.
I see a group of young people from the UK who live in 'care' telling me that all they really need is love and to be listened to.
Despite their difficult, sometimes desperate, circumstances, time-after-time I’ve met children with reliance, creativity and an appetite for joy. Often digging themselves out of their heartbreak by doing something practical, and for others. The ‘strategies’ to make this happen may not be obvious and they may not be about a focus on ‘mental health’. It may be as simple as an opportunity to give to others.
I’m going to be writing several more posts on this topic and drawing upon the work of Jane McGonigal in her ‘Super Better’ movement. She unpacks the term resilience into four categories:
… and has very many useful tools and ideas on how we can develop resilience in each of these areas in ways that are playful and fun and help others develop theirs too.
Far from it being a new theme for Children for Health or a side issue, RESILIENCE is the foundation for ALL the other work we do.
I have worked with young people for over half of my life in some form or another. I see trends. Interventions and approaches come and go all pretty much unsuccessfully.
I have worked with several different generations and have seen them change, adapt and respond to current society and culture in different ways.
I have worked with thousands of young people and see the challenges them come to me with morph as things come in and out of popularity or maybe more appropriate to say is consciousness.
I wrote something about 10 years ago about how we were raising ‘generation disorder’ but either I was too far ahead, or everyone was too blind to see what was coming.
I saw children change their wording from things like…
“I find that really difficult to do”
“I can’t do that, I have anxiety.”
Through the years I saw more and more children get miserable and more and more children identify as having a mental health issue.
Now don’t get me wrong - I for one am delighted that we are talking about mental health more and I am delighted that young people in particular have an outlet. But what I do question is, are we talking about it in an empowering helpful way - something I discussed in an article for The Huffington Post.
What I see in schools and with parents often is:
an unwillingness to discuss, or even entertain, that their child might be able to deal with some uncomfortable issue themselves;
an urgency to jump to the conclusion that something is wrong as soon as the child says they are having difficulty with anything; and
a belief that children should always be happy.
It’s almost as if everyone is so scared and so protective that we are stigmatising ordinary human emotions.
Yes, I know there is a difference between sadness and depression, and I know there is a difference between feeling uncomfortable and anxiety and I also know that, not being a mental health practitioner, I am probably not the one to say which is which. But if we automatically jump to the conclusion that a mental issue is the problem, don’t we perhaps pass the buck, don’t we perhaps:
make it someone else’s problem
give the child a time out card instead of supporting that child to look at ways to address ‘their problem’.
While this might seem harsh and you may be taking a big intake of breath please hear this.
I have had young people tell me how they use their diagnosis to get out of things they don’t want to do.
I have had young people tell me how they make their symptoms seem worse to compete with others.
And the most heart-breaking of all is I’ve had young people with real problems in floods of tears because they can’t get the help they need, or their issues are ignored because depression now seems the ‘norm’ and the services they need are overstretched.
I’m not saying I have the answer. I wish I did, but perhaps what we need to do is have more meaningful conversations about it. And perhaps we need to find a different language. At the moment it everything seems to get labelled under mental health as if anyone who isn’t a 100% happy most of the time they might have a problem. This worries me and I wish we could take the conversation elsewhere.
I wonder if, like Clare said, that we need to stop reaching for happiness and well-being as the end goal and instead reach for something more realistic. Perhaps the end goal is about social, emotional, physical and mental resilience and preparing our young people for life. What if we started talking about resilience and started teaching children how to deal with difficult situations, how to deal with uncomfortable feelings early on.
What if we had supportive family and school systems which put raising resilient children as their number one aim? Teaching resilience skills early on and reinforced throughout a young person’s life would help us easily identify who really needed help and who just hadn’t learnt the life skills needed.
In my work I would say 80% of the young people who self-identified as having some kind of mental health or well-being issue were just lacking the appropriate coping mechanisms and the other 20% really needed the help they just couldn’t get.
Until we can start having open and honest discussions about what is really happening, we won’t find any solutions. We will go on offering ‘piecemeal’ breathing techniques, mindfulness and unsuccessful interventions perhaps because it makes us feel we have done something. And while these might work for some, they are not a catch-all.
What if the questions we asked as parents, teachers and others was, “does this young person need to learn to be resilient or do they have a mental health issue that needs addressing?” we might be able to make better assessments. And I know this has difficulties, I do, as we never want to let one child slip through the net, we never want to have a child unheard, or have them believe we don’t believe them. However, if we go on the way we are we will raise a generation who are unable to deal with the inevitable series of problems that life throws at most of us.
Mental Health and Well-being still has to be our number one priority, it’s something we are failing at miserably, but when the very systems set up to tackle the issues are letting down those most in need maybe we need to think again, find a more empowering way and put young people at the centre of their own support structures.