Dr Ben Spencer is an NHS doctor in the NHS, Vice Chair of Conservative Health with responsibility for policy, and contested Camberwell and Peckham in the 2017 General Election.
I am an NHS consultant psychiatrist, with almost a decade of medical experience working in mental illness.
I’ve waited my entire medical career for mental healthcare to be a priority. Now that’s becoming a reality I should be pleased, but I’m worried that without a clear understanding of what is ‘mental illness’ society may ultimately be worse off than before.
For me, we need a clearly defined approach to mental healthcare that does not confuse the stresses of everyday life with a ‘mental health epidemic’. Instead we must ensure that those who need support and really need treatment can be identified, whilst at the same time developing the coping tools that will enable the entire population to benefit.
The current focus and national debate on mental health, which the Conservative Party is leading and driving change around, is a huge step forward. Investment and development of services was much needed, particularly to ensure mental illness is taken as seriously as physical ailments. The need to equalise their importance has been called ‘parity of esteem’, which the Conservative Party has championed and driven forward in policy.
People suffering from mental illness can suffer the worst stigma in society. For example, people with a diagnosis of schizophrenia are often portrayed as dangerous to the public, even though the evidence shows they are far more dangerous to themselves through risk of suicide. Given the unique position of mental health within the fabric of society, we need to pause for thought in order to be very sure where we are heading with the mental health agenda.
For a start, we need to acknowledge that all the talk about a modern mental illness epidemic has gone too far. Medicalisation of normal human experience (mental wellbeing) can prevent people from developing their own coping mechanisms, impacting on their resilience, and I believe will lead to a higher chance of them developing true mental illnesses in the future.
For example, a YouGov survey in 2016 reported that over a quarter of university students consider themselves to have a ‘mental health problem’ (mainly either anxiety, depression, or both).
Adolescence and early adulthood are stressful – times when some mental illnesses can develop, especially psychotic illnesses like schizophrenia. Nevertheless, while young people may indeed have problems with their mental wellbeing, it would be totally false to assume, that a quarter of university students suffer from a diagnosable mental illness. The fact that it would seem they think they do is very troubling.
Human experience means that there are times when we feel sad, overjoyed, or bereaved. In everyday life we talk about being depressed or being anxious about something. These emotions often occur when dealing with stressful experiences. However, it does not mean that one has an illness such as an anxiety disorder or a depressive episode. These are diseases which can be very serious and debilitating, requiring the appropriate diagnosis and treatment.
Adolescence and early adulthood should be a time to learn how to cope with life. It should not be a path to self-diagnosed mental illness. Rather, it should lead to developing healthy coping mechanisms, focused on mental wellbeing, and leading to resilience. Learning these coping mechanisms requires exposure to stress. We need to be exposed to opinions we disagree with, we need to be free to explore, adapt and develop. But we must not formulate stress and its consequences in itself as a mental illness.
I worry that the mental health movement is now trying to protect young people from all stress, any risk of failure, and the whole range of normal human emotions, dressed up as ensuring good ‘mental health’. People need to experience life and the full range of emotions life offers to be able to build and grow. This means experiencing and living through the good times and the bad, and seeing these not as illnesses or health problems, but a normal part of life in which to learn and develop. Only through experience can people learn for themselves how to navigate life, learn from their mistakes, and to grow and develop. Don’t get me wrong, people may need support and education around maintaining their mental wellbeing. Too much stress is indeed very toxic to people’s health and wellbeing, but this must be seen as different to mental illness and associated mental healthcare.
This must be the basis for the new strategies that we Conservatives are promoting and introducing in order to help those in need. In this, the Conservative Party is leading the way in improving mental health care for younger people and implementing programmes to support mental wellbeing in schools and other settings. However, we must also put a stop to those talking about mental health in hyperbolic terms. They are creating a false epidemic that risks creating a true epidemic of mental illness in decades to come.