There’s a concern that the everyday is being pathologised: a lack of enthusiasm for work becomes a reason not to do it at all
It’s nearly a decade since I had a mental breakdown, which means I am rapidly approaching 10 years since a well-refreshed colleague came buzzing up to me at a Christmas party and asked: “Isabel, what on earth have you got to be depressed about?” If, however many pints down he was, he meant anything by that question, he did mean it kindly. I had been off work for a few months by that point, having fallen apart catastrophically while trying to cover the Conservative Party conference earlier in the autumn. Now, I am well enough to joke that this was probably a rational reaction to my environment, given the Tories were about to enter their period of turmoil after the EU referendum. Back then, nothing felt very funny.
What a change those 10 years have brought about. Now, it seems everyone has got something to be depressed about, and it’s more unusual not to have a mental illness. This week, Health Secretary Wes Streeting announced an inquiry into what he fears is “overdiagnosis” of mental health conditions. There’s an economic rationale for examining this question: the most common reasons for a sickness benefit claim are now mental health problems, and the number of 16 to 34-year-olds off work with long-term mental health problems has risen by 76 per cent since 2019. But there’s also a clinical concern that the everyday is being pathologised: grief becomes a medical problem to be treated with pills, a lack of enthusiasm for work becomes a reason not to do it at all.
I never ended up on out-of-work benefits, partly because I had an employer who did more for me than most would bother to, and also because I always assumed that at some point I would be well enough to work consistently. I’d never really contemplated that my diagnosis meant I should just give up. The message that many young people seem to have taken, though, is that mental ill health is a destination, not something you might pass through, or at least learn to manage.
This, though, is also a rational reaction to the environment these young people have lived in for the past 10 years. When I fell ill, we were still being treated to the “it’s good to talk” mantras. But much like a conversation with an inebriated Christmas partygoer, those slogans didn’t have much more depth: while the discourse about mental health – particularly moderate illness rather than severe, psychotic illnesses that lead to people being sectioned – has ballooned, the help available hasn’t. So reach out for help – but then find there is a waiting list so long that it has been closed for new applications.
You might not have to suffer in silence, but you still won’t be able to talk to a professional about your suffering for a year, by which time your condition may well have worsened significantly. No wonder young people, who may have grown several inches in height as they waited for the child and adolescent mental health services to respond to them, feel mental health is a destination. That’s precisely the message we have given them: if you’re ill, you won’t get much help to get better.
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The pandemic didn’t help with that, either in terms of access to psychological therapies or the wider messaging about health and work. Work suddenly appeared to be a bit optional. Couple that with the overpathologisation of normal feelings and you are suggesting to a young person that their feeling of dread on a Sunday night might be something they should see a doctor about rather than a perfectly normal adult feeling.
Ten years ago when I gave careers advice to aspiring journalists, I’d find myself dispelling their delusions that they might become a leader writer aged 21. Now, I tend to focus quite heavily on the possibility that while this may be the best job in the world, you won’t always wake up feeling like doing it – and that that’s normal.
I don’t always feel like watching the hearings of the Lampard Inquiry into mental health deaths in Essex, for instance, but I have come away from the evidence that is still being heard by that public inquiry with the firm conclusion that we are still woeful at treating severe mental illnesses, for all the fluffy influencer talk about depression. Streeting has commissioned top figures in mental health to do his review. They may well find that the failing isn’t in our young people, but in the assumption by those running the system that a discourse about mental illness would be enough. It turns out that, in fact, it wasn’t good to talk: action would have been better.