This mental health revolution will fail if it’s too individualistic.

The members of the royal family William, Kate and Harry, addressing the effects of losing a mother at a young age on mental health has been received as an admirable and hugely helpful gift to the fight to end stigma around mental illness. But, as someone who believes the current mental health crisis is intimately tied up with plummeting social circumstances and a greedy disrespect for what human beings need to live healthily and normally, I find the praise and admiration difficult to jump on board with given how starkly different the world the royals live in is. There’s only so much application and insight that can come from a family with unimaginably different lives, opportunities and resources to our own. If we only see mental health as a problem fundamentally existing at the level of the individual person, this lack of representation from the case of the royals would be irrelevant and invisible. In fact, there’s a lot not-in-common here which has a lot of explanatory power and will be overlooked at our peril.

It is not the case that only certain people, with ‘REAL PROBLEMS’ risk ever suffering with mental illness. It’s clearly a very indiscriminate phenomenon. But in considering this, the entanglement of genetic and social causal factors in instances of mental illness are really brought out, each with differing effects on what our definition of mental health should be like. There are important differences between cases like a 15 year old boy with a family history of mental illness experiencing symptoms of schizophrenia as he encounters puberty, to an overworked mother trapped in an exploitative job caring for children she feeds before herself beginning to struggle with anxiety and panic attacks, to an elderly woman who has just lost her husband of 40 years, while battling ill-health and the relinquishing of her independence and hobbies. What I’m getting at is three possible components influencing mental illness which mould slightly different definitions of it; genetics which are a deviation from the norm, socio-economic factors which push normal capabilities to snapping, and finally events which make proceeding mental health difficulties almost normal and to be expected, challenging the ‘deviation from good health’/’something going wrong’ conception of mental illness.

Now, no mental illness has a 100% concordance rate in identical twins (as far as I know?), which suggests all have an environmental component or trigger, but the variation found across mental illnesses in their nurture vs nature constitutions highlights how vast the range of conditions we class as mental illnesses are, perhaps unhelpfully vast. Mental illnesses with higher rates of genetic concordance tend to be quite rare but still found globally at more consistent proportions, for example schizophrenia has 50% concordance rate in identical twins and affects on average 0.3-0.7% of people across the globe. Depression and anxiety, on the other hand, are common enough in the US to affect 17% and 28% of people respectively, but rates of depression in Japan are as low as 3% and even completely absent elsewhere, specifically in modern day aboriginal societies. The rise in mental illness in the US and UK is clearly fuelled to some extent by increasingly common social adversities. Researcher Ilardi lists social factors which appear to affect levels of depression as: lack of exercise, poor diet, too much time indoors out of sunlight, unhealthy sleep routines, lots of negative mental rumination, and lack of meaningful social connectivity.

Combine these factors within a right-leaning neoliberal and capitalistic framework much of the west is experiencing right now, and a lot of the mental illness we see affecting as many as 1 in 4 people becomes a blown-up analogy of the woman whose capacities are stretched to snapping point, and not just something out of our control that we see naturally occurring at consistent levels of prevalence worldwide. Mixing up the two conceptions might lead us not to notice that we might be feeling the effects of the fact most of our lives are being spent sitting still, behind desks in jobs which overwork us, keep us stressed, don’t pay well, leave us with minimal free to time to pursue hobbies and don’t provide meaningful fulfilment or prospects. It’s a work ethic that political parties like the conservatives are only going to push onto more and more people, what with ‘incentivising’ people to work by taking away their benefits regardless of whether they’re actually able to work or not, into jobs in which they have no intention to ensure provide an adequate level of pay and protect the rights of workers. We are left with less time to cook healthier meals and less money to buy healthier ingredients with. Young people today face a more competitive job market than ever in order to have a stab at affording more expensive rent, houses and living costs, and I can tell you, it takes a toll. We are also living in a more technologically connected world than ever, but with this comes exposure to the happy lives of our friends and the world’s beauty standards, increasing the amount of negative rumination on ourselves, our achievements and our appearances.

It’s clear that an improvement in these areas and an attempt to govern life in a more secure and healthier way will alleviate a lot of suffering in this mental health crisis. I also think that a particularly comprehensive, all-encompassing and well-researched improvement of society would also help ameliorate – though certainly not completely extinguish – instances of mental health like the grieving older woman that seem inevitable regardless of societal prosperity. This would include action explicitly centred on mental health and human fulfilment, such as prioritising extensive and valued support networks, offering networks of others who have been through the same traumas, education on support and maintaining interpersonal relationships, well funded therapy and counselling, emotion coping techniques, warning signs in your life and yourself, vulnerabilities you inherit just by being a woman, or black, or gay, and some good old wisdom on love and death.

But an overly individualistic focus and approach to mental illness will hamper this. The detailed qualitative stories about individual’s experiences of mental illness are important and crucial to their recovery, but if this aspect is too dominant in the overall discourse then how could we possibly see the trend? The importance of ‘talking about it’ for our own sake will only get us so far. We risk keeping hidden not only a very important common cause of this widespread mental anguish, but what societies and governments must provide in order to keep us healthy and fulfilled. Seeing friend after friend, celebrity after celebrity, individual after individual speak out about their mental health struggles is becoming reminiscent of Brian yelling ‘You’re all individuals!’ at villagers and all the villagers yelling back ‘yes, we’re all individuals!’ – there can’t be a deviation from the health norm in upwards of 25% of us, it just doesn’t work out.

The royals are not highlighting any of this. They are highlighting the most predictable level of mental unease – that it will feel shit when your mother dies and you are young. A lot of the stigma around this kind of trauma is not just mental-illness-stigma, but a thick stodgy mixture of a lot of things wrong in society – the main one here being toxic masculinity stopping men from talking about their closeness and dependence on women (You’ve got to wonder, is it really harder for men to say that they are depressed, as a scientific biochemical mishap, than talk about how the strength of some of their feelings are starting to debilitate them?). Theresa May and the conservative party are certainly not highlighting any of these common causes, despite their pledges to make mental health a priority. I don’t see any of their policies addressing these societal factors. We should be wary of this. We should be wary of rich and powerful groups who are less likely to suffer the worst and more able to get the best help available pushing down the conversation about these issues through the funnel of individual experience, moulding mental health into something slightly different than something that by its very nature will be affected by social factors. Not just chemical imbalances and quirks to individual.. after individual… after individual…

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