As World Mental Health Day (October 10th) descends upon us, advocates across the globe continue to raise awareness, push back on associated stigma and educate others on tough-to-talk-about topics, such as suicide prevention and trauma-related illnesses. An initiative originally created by the World Federation of Mental Health in 1992, this annual one-day observation dedicated to education and advocacy, continues to fight the good fight some 27 years later.
I wholeheartedly support days such as this; any initiative which seeks to create positive recognition of and dedicated action towards an important public health topic is doing good work. But like any worthy issue requiring extra effort to improve cultural consciousness, it still gives me pause. Why, as a society, are we still breaking our backs to demonstrate that mental health is just as important (if not more so) than physical health?
State of the Nation
1 in 5 Australians (20.3%) will experience a mental illness in any given year and over 45% of us will experience mental illness within our lifetime. In relative terms, chronic illness (such as arthritis, cardiovascular disease, cancer & diabetes) will affect 50% of – or 1 in 2 – Australians within their lifetime. It’s interesting to note that the definition of chronic illness here includes a small nod to mental disorder, so prevalence across the board is hard to ignore.
We spend so much time in medical centres and GP offices, virus and infection treatments remain (mostly) accessible and cheap, with pain medication handed out like tissues at a wedding. Last year, 87.8% of Australians visited their GP at least once, with 4 out of 5 patients reporting that they see their General Practitioner multiple times a year. By comparison, only 1.2% of the population have recently reported attending an MBS (Medicare Benefit Scheme) psychologist appointment (subsidised). Interestingly, even when visiting their GP, patients talk about mental health concerns more than (62%) any other health issue.
So even when we are visiting our ‘normal doctor’, we are wanting to address psychological health issues (anxiety, mood disorders and depression) more than the common cold or physical pain-related problems. And yet, broadly speaking, we are still treating mental health as having less significance than physical well-being. We do not baulk at needing antibiotics, or cringe when someone suggests a flu shot, yet we often question the requirement for mood disorder medication or the help we may receive from a visit to a psychologist.
So why is this?
Seeing is Believing
Tangibility is a powerful force.
The materialism of physical pain is almost impossible to argue with. We can see a bruise, touch a lump, feel the burn of indigestion. Redness marks inflammation and scars prove that once upon a time, whether it was yesterday or years ago, we experienced physical harm. We can make a very easy – and substantial – connection between the place of hurt and the fact that we’re in pain.
Pain of the ‘mind’ induces a different sense of reality. It is visionary and driven by thoughts and feelings. It cannot be diagnosed with a stethoscope or patched up with plaster and bandages. It is the abstractness of and inability to ‘see’ mental issues which can prompt the common response of “it’s all in your head.”
And whoever says that to you is actually right. Just like it is also ‘all in your head’ when it comes to the physical. An article from Psychology Today explains that, “when people feel emotional pain, the same areas of the brain get activated as when people feel physical pain: the anterior insula and the anterior cingulate cortex.” Being able to link the same areas of the brain to both psychological and physical pain brings a level of authenticity to mental stress or illness; if an EEG (read: brain scan) can demonstrate neural flares when the body and mind are in distress, then it must be true!
The trouble is we can’t go around showing others pictures of our brain when explaining our mental health issues. Our partners, families, friends and workplaces have to take us at face value; we have nothing but our word to back us up. And it is this disparity between the ability to see someone’s physical pain, but only hear about their psychological hurt that has created the health war and defined the system built to manage our many ails – both mentally and physically.
Segregation of Services
In our recent article, We Need to Talk About Therapy, we discussed the systemic issues of accessibility when it comes to mental health services. Psychologists are not only expensive (and rarely bulk-billed), they are also viewed as specialist and oftentimes, a luxury. They are not nearly as nationally dispersed as General Practitioners or medical centres and they come with a stigma that most GPs do not. Anxiety, depression and mood disorders are seen as something we should deal with privately versus a broken arm or stomach virus which the public health system can openly attend to, as well as, pay for.
Medical centres and hospitals should have ease of access to counsellors and mental health professionals. If 62% of us are heading to our GP to discuss psychological illness or pain, why are we not being immediately directed to a doctor who specialises in those areas – one who can be bulk-billed and is located in the same building? Instead we go through the rigmarole of a Mental Health Assessment, a GP referral letter and a half-hearted suggestion to see a therapist.
In many Australian workplaces, we have employee benefit schemes which include discounted gym memberships, dedicated lunch-time fitness sessions and healthy lifestyle workshops to improve productivity. We spend a disproportionate amount of time fighting the alleged obesity epidemic and yet, if we had a better handle on managing mental health issues, we would be more focused on body acceptance and less concerned with fatphobia. I guarantee you the ‘epidemic’ would cease to exist.
Some organisations have an Employee Assistance Program which offers phone and/or off-site counselling services, a handful of which are paid for by the business. But we still have no immediate access to mental health services. If an employee experiences an anxiety attack or mental breakdown whilst at work, we generally send them home with an eye roll and a promise to see a counsellor. But when an employee falls over in the workplace, we call for the Health & Safety Advisor, fill out an incident report, call an ambulance and ensure management checks in regularly whilst they’re off work. In all my years as a professional leader of people & culture, the most prevailing issues brought to me were mental health related and still, we drag the chain when it comes to psychological safety at work.
The continued stigma of mental illness, the segregation of health services and the lack of accessibility, particularly in remote or low-socioeconomic areas, is what continues to drive our suicide statistics upward. We need change and we need it now. One day out of the year focused on improving mental health awareness is simply not enough.
Education and Integration
We believe that the answers lie in education and integration – whether at school, in the workplace or within the media marketplace. If primary and high school Physical Education & Health classes incorporated an equal amount of mental health curriculum (as physical), we might be seeing a downward trend in medicating depression & anxiety. If body acceptance and inclusion learnings sat alongside that of the Pinch Test (eye-roll emoji), we just might eradicate disordered eating and the illnesses that encourage it.
We believe that toxic positivity (brilliantly explained here) plays an enormous role in the lessened value placed on mental health issues. Using phrases like ‘never give up’, ‘good vibes only’ and ‘you’ll get over it’ to someone experiencing psychological distress do the exact opposite of what they are undoubtedly intended to do. We need to educate each other on the value of validation and empathy. People in roles of authority (doctors, teachers, politicians, etc.) need to better understand how to elevate public discourse around mental health issues without dismissing their significance. Telling sufferers to ‘just think positively’ will not make the problem go away.
Health needs a good PR campaign; a step-up in branding.
When we think about healthy living, it shouldn’t all be apples, activewear and fit-bits. When we visit the local medical centre, we should be able to walk directly into the room of a mental health professional and get bulk-billed for the privilege. When our kids are learning about health in school, they should be taught mindfulness and meditation, that anxiety is more common that the average migraine and that’s OK; as a society, we see both these issues as painful and requiring treatment.
This World Mental Health Day, we ask you to actively work on seeing psychological pain as significant a concern as physical illness, and push society and our government to treat it as such. We ask you to challenge your definition of health as a whole. And we ask you to believe; even when you can’t see.
