What is the first thing that pops into your head when you hear the words ‘mental health’?
Think for a moment what comes to your mind.
Does your answer match the World Health Organization (WHO) definition? They describe mental health as:
“… a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community.”
On the basis of this description we can conclude that mental health is a neutral if not positive thing and we all have varying degrees of it.
With World Mental Health Day kicking off this week, this is an important question for everyone to think about.
TCC completed an evaluation of a mental health intervention for a Clinical Commissioning Group (CCG) in London. We asked the same question to people on the street, yet the response was very different:
“Crazy person”
“Someone who needs help”
“Dangerous to society”
“Unbalanced”
Similarly, a large majority mentioned disorders or negative symptoms. Only a few spoke in similar terms to the WHO. For most, mental health meant ‘something wrong’.
This opened up the question for me of what influences how we view mental health. When I ask colleagues if they thought of mental health as positive or negative they didn’t jump to WHO’s definition either.
My experience of registering as a new patient at a GP practice shed light on one of the problems we face in challenging and overcoming stigma around mental health. The registration required the standard things, urine sample, address and my medical history. The form ended with the question “Do you suffer from:”, followed by a long list of medical conditions such as diabetes, respiratory diseases and heart conditions. Alongside them was mental health.
Do I suffer from mental health? I wasn’t sure what that meant, so I put a question mark beside it. “Well, do you have it or not?” the nurse asked me when I gave it back to her.
I was thinking of course that I do have a mental health – according, at any rate, to the WHO definition. But it was clear that this wasn’t what she or the question on the form meant. “No, I don’t have mental health,” I told her, to make things easier.
This is anecdotal evidence, of course. But it goes some way to explain why, for the average person, the connotations of mental health are often negative – why stigma exists and is hard to eliminate – it’s endemic even within our health system.
The theme of World Mental Health Day is psychological first aid and the support people can provide to those in distress. This is absolutely vital, and reflects the big steps forward made in recent years in getting people to take mental health seriously.
But it seems that a crucial first step will be in building a ‘wellness agenda’ for mental health that emphasises prevention as much as cure – that everyone has mental health to varying degrees. Mental health needs to become something more than just the absence of something wrong.
We’re already moving in the right direction. But my experience suggests that, when it comes to mental health, we could still do with the sort of “apple a day keeps the doctor at bay” received wisdom that already exists in other parts of the health sector – for doctors and patients.
Merel Spijkerman is a Consultant at The Campaign Company and specialises in health and behaviour change projects.