mental health; the issue that never quite was

Mental health is slowly being discussed in less defining – and damning – terms, but there is a still a huge lack of real support for sufferers. While self diagnosis, self medication and self help may benefit the department of health, there is an urgent...

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23 December 2016, 9:25pm

Nick Knight, Pale Rose

Having suffered periods of depression - and always feeling as though I would have benefited from living in a society that considers mental health on a sliding scale - I often wonder if society, in 2016, is any better equipped at dealing with mental health and its iterations? Not a binary distinction between the well and unwell - or from a late capitalist perspective: those capable of earning money and not - but as something we are constantly experiencing as a result of our circumstances and behaviours, like physical health. To me, it always seemed that approach would be the only way of eradicating the shame and stigma that prevents so many people from seeking the treatment they need.

This year, if there was anything that helped us come closer to achieving that, it was TV, film and music. The BBC's Fleabag by Phoebe Waller-Bridge being a standout example, touted as the latest (and greatest imo) example of the sadcom genre predicated on the tragi-comic fall out of depression, social anxiety, grief and everything else in between. Season three of Bojack Horseman launched in June with arguably a more candid account of the sickness borne of celebrity culture than the past two seasons combined. In literature, Olivia Laing's The Lonely City: Adventures in the Art of Being Alone took the unexpected line of considering whether our need for constant human contact is itself a form of neurosis. While Amy Liptrot blew us apart with her gallant account of addiction and recovery on a wind beaten Orkney in The Outrun.

In October, Kid Cudi shared with his fans a Facebook post in which he stated that he was seeking treatment for depression and suicidal tendencies. He joined a tradition, albeit infrequent, of rappers shunning the bravado of the genre in favour of a more transparent approach to mental health - Biggie's Suicidal Thoughts immediately springing to mind. In the same month, Amanda Seyfried spoke openly about her decades-long battle with OCD and the importance of reducing the stigma that surrounds mental health treatment. Meanwhile, New York singer/songwriter Mitski, whose third album Puberty 2 became the definitive adult emo soundtrack of late 2016, spoke candidly online about her struggles with mental health.

These moments, I think, are no less significant in our collective march towards a society that is better equipped at dealing with mental health, than advancements in prognosis and treatment. Helping as they do to transform perceptions of various mental health conditions into distinct modes of identity. What we've seen in 2016 is that the edges are becoming more frayed, the definitions and parameters more varied, as personal experience trumps the prescriptive taxonomies of 19th and early 20th century psychologists and psychoanalysts. The physical walls of the institution might have been dismantled 70 years ago, but it's taken until now for the ideas they stood for to be almost entirely eradicated. Depression and anxiety in particular are terms that society has come to accept and understand as treatable conditions, as opposed to life sentences, stigmas or points of shame. To a lesser extent, there is also more widespread understanding of conditions such as bipolar and borderline personality disorder than ever before (though admittedly, much more could still be done). Mental health is increasingly being incorporated into the language of every day life, much like physical health, where it is able to more effectively reach, support and engage those affected. At the same time, casual and offensive use of mental health terminology seems to be on the wane.

But public perception alone can't tackle the steep rise in mental health cases reported in recent decades. And while we acclimatise to the idea that mental health plays a central role in all of our lives, more official frameworks seem determined to relegate it further and further to their fringes. What was concerning before 2016 turned into an emergency in October, with reports that there had been a 50% increase in cases of detention under Section 136 of the Mental Health Act, used in cases of people threatening suicide or behaving in a distressed or agitated way. Forces have attributed the rise to a lack of psychiatric care in the community owing to a lack of available funding.

Meanwhile, as we see a better public understanding of mental health and a proliferation in the number of related terms, limited funding and resources within the NHS present little hope of this being matched by an equally diverse and representative range of treatments. While a highly effective means of tackling certain mental health conditions, there are concerns that antidepressants are being administered too freely as a readily available replacement in cases where other forms of medication and treatment would be more suitable. Speaking to The Guardian earlier this year, Vicky Nash, Head of Policy and Campaigns at the mental health charity Mind, expressed concern for those living in parts of the country where talking therapies are not readily available. Head of Policy at Rethink Mental Illness, Gillian Connor, also claimed that an 'overstretched' and 'underfunded' NHS meant antidepressants were often prescribed in lieu of anything else. And even those who do eventually qualify for more holistic treatment are still being put through the farce and indignity of enormous bureaucracy and limited resources; in February it was reported that more than 500 psychiatric patients a month are being forced to travel over 50km to receive acute care.

With impossibly long waiting lists for treatment that runs the risk of being patchy or incorrect at best, sufferers might be tempted to explore other avenues. Casual online searches present fertile ground for anyone looking to find solace through shared symptoms - and by connecting with others and journalising, we are able in this way to validate our own experiences where the health service fails to. Not having people IRL who we can easily speak to about our feelings can exacerbate - if not cause - some mental health conditions, and might be at least partly answered by an online audience of listeners. Of course the pitfalls include online abuse and in some cases, an over dependence on an illusory cohort of limbless avatars. The former should not be underestimated by anyone suffering from low self-esteem. It's important for those who do share to be honest with themselves about how it feels to receive negative attention, which regrettably, comes with the territory. Abuse, even online, can trigger past trauma and though we're all loath to let the trolls win, pretending otherwise at the expense of our health seems counterintuitive. So widespread is mental health discussion that in October, Instagram launched a feature allowing users to flag posts they find concerning, in what seems like a mechanism ripe for miscommunication, abuse and paranoia. Those hit by such an alert will be sent a private message by the service linking them to friends and mental health services in their local area.

Are those people who are not receiving adequate care, well advised to seek it in the house that Pepe the Frog and Joanne the Scammer built? It seems all too convenient that a culture of DIY mental health care dressed up as wellness, vulnerability and online sharing should occur at a time when the Department of Health under Jeremy Hunt has abandoned its side of the deal. Like so many areas of life in the UK in 2016, a huge explosion in the language of self-care reflects a necessity borne out of shortcomings in the state's own provision of service. The broadening of public awareness, the fraying of traditional definitions and the ensuing sense of empowerment among sufferers of mental health conditions is a positive thing. But it has also given policy makers a get out of jail free card and created a private industry that remains largely unregulated, as well as a proliferation in the number of home remedies being used unchecked and unvetted by qualified professionals. Sure, the old language of damnation has been lifted and in its place a softer and more encouraging message of self-care. On the one hand, it empowers and uplifts, making us aware of the ways in which we can all affect our own happiness. On the other, it tells us to be responsible for our mental health at a time when racism, xenophobia, isolation, hunger and poverty are rife and creating situations in which no amount of scented candles can save us. It is also a language being used by powerful advertisers. Keep calm and carry on and if you can't, download this app. Subscribe to this website. Sign up for this overpriced course of therapy.

As 2016 comes to a close, there have never been more avenues to explore in terms of diagnosing and treating our mental health. We are free to choose. Unqualified masters of our own fate, each navigating our way with only the advice and support of each other.