When it comes to young men and mental health, talking about it isnt enough.

Published by The Debrief (www.thedebrief.co.uk) May 2017 with Judith Apps of The Eden Practice contributing.

Earlier this month, Mental Health Awareness Week concludes for another year leaving people in the public eye are discussing how we need to talk about mental health more than ever. But this is a conversation we need to be constantly having - not just for seven days of the year. Suicide is the biggest killer of young men under 45, and two-thirds of people admitting they’ve experienced a mental health problem, it’s obvious we’re at the eye of a mental health storm. Recent conversation has focused on young people – young men in particular. They’re a demographic that has long struggled to have the space to talk about their mental health issues. Often told to ‘be a man’, for a long time even the idea of young men discussing things like depression, suicidal thoughts or anxiety was unheard of, with very few people even addressing them directly. 

While some of the high profile names that have committed to the mental health conversation include Prince Harry and journalist Bryony Gordon, artists from across the creative spectrum have also been getting involved. Singers Laura Mvula and Zayn Malik have spoken about their struggles with anxiety, Years & Years frontman Olly Alexander is making a documentary about LGBT mental health, rapper Stormzy has been candid about his depression, and actors Brad Pitt and Catherine Zeta-Jones have opened up about their mental health struggles. We might be in crisis, but the calls to talk have never been louder. But can the arts truly add to the mental health conversation, and more importantly, is simply talking about our mental health enough?

Speaking to creatives from different industries, it’s obvious there are both young men and women expanding the ever-growing mental health conversation with their art. George Perrin, the director of Every Brilliant Thing (a play that follows a boy’s list of things worth living for following his mother’s first suicide attempt), spoke to me about the potential theatre has for addressing mental health: ‘I think theatre engages with what it means to be alive today better than any other art form, and new plays can do this particularly well. This includes the positive and more challenging experiences of our mental health. A close friend has worked in mental health awareness for most of his career. He talks about the negative effects of poorly informed and inarticulate media combined with not talking about difficult experiences both privately and publicly. If art – and in our case theatre – can help people feel more comfortable and confident addressing the challenges in their life (with both those close to them and the wider community) then I think this is a good thing.’

For other artistic people, it’s the act of creating something in and of itself that can have a positive effect on mental health. Last month radio producer James Peak and filmmaker Duncan Crowe wrote Scoundrels, a book chronicling the back-and-forth banter between two fictional detectives. ‘I can't claim that Scoundrels addresses mental health issues specifically, only that the process of writing has been very rewarding for us’ James tells me. ‘Medical professionals speak of the talking cure, and for me getting stuff down on paper seems to provide a really cathartic release. This project has, numerous times, taken me away from the stresses and strains of normal, everyday life, and offered a pick-me-up for the soul. Writing gives you permission to re-examine the world through your characters, and it’s inevitable that if you're writing a comedy you're going to find that light, and funny. I think creating anything – whether it's a painting, or a vase, or a piece of music or a dance routine or a sentence – is a force for good. One other thing: I'm too old to be considered a Millennial, but one thing I notice about the Millennial generation is that they have fostered extraordinarily positive ways of communicating emotion through communication, which is in stark contrast to my parents’ generation who are prone to bottling stuff up. I suppose on some level all art is an attempt to communicate, and all art, in whatever form, is a release of pent up emotion.’

James’ writing partner Duncan echoed finding solace in his writing, saying: ‘turning down time into something meaningful has been extremely good for my own state of mind, and helped stave off the demons of self-doubt and uncertainty that is part and parcel of the freelancer's existence. I would agree that the book has helped take me away from the day-to-day stresses and strains, and it has also given me a goal and focus. Art can sometimes act as a kind of therapy – it can lift your state of mind or it may resonate in a way that really connects. Writing Scoundrels was never consciously about that, but over the last 2 years it has always managed to put a smile on my face.’

An ambassador for male suicide prevention charity CALM, theatre-maker and comedian Jack Rooke’s new BBC Three documentary Happy Man was the most recent in a long line of his creative projects exploring male mental health. ‘To a certain arrogant level, I think that what I have to say about grief and mental health is better than what a lot of other people have to say about it’ Jack says. ‘It’s not like I’m trying to ride off a bandwagon – it’s that I’m only 23, and half of my life has been affected by grief and mental health issues. I can’t speak about things I haven’t lived through. It just so happens that Dad died when I was 15, and my mate Olly killed himself when I was 21. And those are the things I feel most qualified to talk about because they’re the things I’ve had to overcome.’

However, despite seeing the positives in using art to discuss mental health issues, Jack is clear that talking isn’t always enough to make a difference: ‘losing Olly was when we realised that actually talking isn’t only the answer, and it isn’t necessarily what’s going to save lives. What is going to save lives is a mixture of being able to speak about mental health, tackling the stigma of it in certain places and areas, but also holding the government and our infrastructure accountable for its failures. Olly had struggled with depression since his teens. He knew about CALM, he knew about MIND, he knew about mental health services. He got diagnosed, he was on medication. Olly had all the support available, but what he didn’t get was the interventions he needed – the infrastructure – at the times he needed them.’

Jack continued: ‘over the last 18 months to two years the whole debate around mental health has been so saturated with calls to talk, but it’s not enough anymore. The most damaging thing about the talking debate is that if you suddenly put out all these calls for men to stand up and talk – and they pluck up that bravery, defeat that masculine stiff upper lip type conditioning, buck the trend and they sit in their GPs office – and their GP says “sorry, there’s an 18-24 week waiting list?” No wonder so many men are killing themselves in NHS care. The numbers of young men actually killing themselves when interventions are in action have increased massively over the past few years, and it’s because there isn’t the infrastructure to do it properly. The more that media organisations focus on talking and ignore government accountability, the less that actually gets done.’

Jack is right. The reality is that for your average young man or teenage girl or stressed single parent without the money for private healthcare or therapy, being told it’s ok to talk about their mental health simply isn’t enough. We might be speaking about mental health more than ever before, but we also have a government implementing austerity measures with devastating consequences for mental health provisions in this country. When Prime Minister Theresa May pledged to ‘tackle the stigma’ of mental health issues earlier this year, Shadow Minister for Mental Health Luciana Berger responded with ‘we’ve seen a measurable reduction around the taboo around mental health. That is an important goal, but it’s not going to solve our nation’s mental health crisis.’ Over the past three years, unexpected deaths in England’s mental health trusts rose by 50%, while spending in regions across the country is being cut by millions. Since the Conservative government came into power in 2010, over 6,000 mental health doctors and nurses have been cut, and charity MIND has pointed out the further failings when it comes to NHS care for people from BME communities. Worst of all 54% of people with mental health issues wait for over three months before receiving NHS treatment, with12% of people waiting for over a year. Our government is failing people with mental health issues and we need to do more than accept their lack of practical action with feeble cries to ‘talk more’.

As the calls to speak about mental health reach fever pitch, where do we go from here? When it comes to practical advice for people struggling with their mental health, ‘not everyone knows what they need,’ says Judith Apps, a Counsellor and Psychotherapist.’ It can be hard to go to the GP without being able to name what is wrong, [and] even if there is a sense that counselling or therapy might be a solution, how to get hold of [it] might present another issue. For many the NHS is the first port of call, and if the pathway through mental health is difficult, it might prevent some who most need access to care from getting what they need.’

Dr Meg-John Barker, a psychotherapist and self-help writer, emphasised how class (amongst other oppressive factors) is ‘One major barrier [to good mental health care] is financial. If you have less money (or no money) then it is much more difficult to ensure that you see a practitioner who is a good fit for you, and you may well be limited to a certain number of sessions. Wealthier people have a much greater range of private options available to them and can shop around to find somebody they have a good relationship with (which is the most important factor predicting success in therapy). After that, I would say the stigma around mental health is still a massive barrier. People can be scared to acknowledge any struggles to themselves and others. For many groups, it goes beyond an issue of stigma and shame, to being actually dangerous to admit to mental health difficulties; for example in terms of risk of losing work or having control over treatment taken out of their hands. Again, it is generally the most marginalised groups in terms of class, race, disability, etc. for whom this is most risky.’ Dr Barker continued: ‘the whole NHS at the moment [is] hugely under-resourced and under-staffed. We need far greater investment in the NHS to enable it to support all those with mental and/or physical health needs, and we need to become a more welcoming country to immigrants – many of whom have just the expertise that we need.’ 

Given the current lack of investment in the NHS, I am very worried. It's just one more area where we see a widening gap between the rich (who can afford private therapy) and the poor (who can't). If we want to tackle mental health problems we need a more equal society. Unfortunately, people in the public eye tend to tell very particular stories around their mental health issues: often stories where the issues are seen as purely biologically caused, and stories where they 'got better'. It's important to recognise that many mental health difficulties are caused by social problems and that many people do not have the resources that celebs have to get help and support.

 It’s clear that we need to move beyond talking – we need to take action. Writing to your MP, researching which NHS Trusts are facing the harshest cuts, voting in the upcoming election – there are many different ways you can help your voice to be heard. As Jack Rooke says: ‘if you really care, you need to challenge the infrastructure that is letting people down. Year on year I’ve felt that the “talking” debate has become less of a useful thing for the mental health conversation, and more of a smokescreen and a distraction to what could actually solve the issues. I’m not saying that talking isn’t important – there are obviously many people, many communities, where the stigma is still so real – but we need real solutions, more investment, more money in the NHS.’ Without all of that, talking is just that: all talk.