Tuesday 17 March 2020

Mindfulness & Resilience — Putting a Plaster over the Need for Serious Mental Health Care?

Amy reflects on the narrative around self-managing mental health issues and the current picture of student support at universities.

- Amy Wells

Self-managing your mental health is great, if you are mentally well enough to build your own toolkit of resilience and can find the energy and time to make sure you roll out that yoga mat and do your five “ways to wellbeing” every day. It’s really important we all take steps to look after our own mental wellbeing through things like practising mindfulness, which can reduce stress and increase your ability to control your emotional responses to everyday situations. However, I’ve been pretty sceptical recently re: the boom in self-care messaging and the narrative around personal resilience.

It seems to me that these ideas are being promoted in the lethal absence of a properly funded NHS, social care, and third sector mental health support services and initiatives - pushing the responsibility of looking after your mental health onto you, as the person who may well be struggling too much to even look after your basic physical needs, let alone engage with these lovely ideas of wellbeing. What’s more, some of these have been exploited into business ideas, with many small companies now pushing (often quite dodgy-looking) products or commercialised fads designed for wellness and self-care (this can put people off the whole idea, meaning they might not engage with the bits that can actually work like meditation). It’s similar to the way universities offering puppy therapy is nice, but that’s about it. It’s a lovely way to promote de-stressing, but it absolutely cannot be funded in place of a fit-for-purpose counselling system that doesn’t have to close its doors to students every term and can offer an adequate number of appointments. 

Mindfulness, stress-relieving activities, and other techniques for better mental wellbeing have a really important part to play in the prevention of mental health difficulties spiralling into enduring conditions, but they can never be used as a stand-in for professional and specialised support. In the same vein, the idea of resilience should be promoted as a positive tool to get better at recovering from setbacks in your life without them wiping you out, which is a very possible and very positive goal for most people, but should never be used to shame people for not being able to cope. As a little side note, I think resilience has grown as a concept almost as a response to the “special snowflake” narrative that surrounds my generation —you’ve probably heard some variation of “toughen up, we just got on with it and we’re doing just fine” (spoiler — they’re emotionally repressed and definitely not doing just fine). My generation, more than ever before, powerfully owns its emotional vulnerability and looks out for others’ feelings, rather than shoving everything deeply into a vault or treating people poorly, and to some that apparently makes us weak, ‘snowflakes’ ‘lacking resilience’ or another buzzword of the bitter over-50s: “triggered”. It’s a load of rubbish, so don’t take it. 

A really key point, moving away from my bashing of older generations (#notallover50s), is that resilience and self-care cannot be taught without also teaching people that it is absolutely okay to not be able to handle things by yourself sometimes — loving yourself is about listening to your mind and body telling you when it’s time to get help. But there’s a problem with pushing the message, one of “ask for help if you need it”, because I see so many other young people building up the courage to finally reach out for help only to get placed on that absurd waiting list or be told they’re too ill or not ill enough. Hope is lost, problems spiral, and the responsibility for caring for an individual fall back on the shoulders of unqualified friends and family. Our support services — charities, NHS support groups, specialist advisory organisations — are on their knees, inadequately funded organisations are overwhelmed by the increasing volume of people needing serious help for issues of mental health, and now more than ever, we need to remember that health is a human right. 

The last time I checked, less than 2% of the public health budget was spent on mental health. Suicide is now the biggest killer of my generation. I am devastated that we still live in a society where we lose people to service waiting lists and support inaccessibility. I’ve seen too many friends faced with the horrible reality of not being able to find help for their eating disorder because the BMI threshold has been narrowed, or finding themselves on a year-long waiting list for support from the local support after rape and sexual assault charity, or unable to afford private counselling. In Leeds, many of our local services have 8+ month waiting lists or are closed for further referrals, like IAPT (now Leeds Mental Wellbeing Service) which offers CBT and counselling, Leeds Mind, Leeds Personality Disorder Service, and Leeds Women’s Counselling and Therapy Service. 

Ideas of mindfulness are actually a small beacon of positivity to emerge from what I don’t shy away from calling a crisis, but I’m scared to see them taking over the conversation and dimming the spotlight that needs to expose the dangerously weak state of our mental wellbeing services. The majority of mental health issues are formed before the age of 24 (and a lot are formed much earlier), so we need to be really careful with how we promote these concepts in schools to make sure young people know how and when to reach out for serious help, and more importantly, they need to know that services for young peoples’ mental wellbeing exist and are actually fit for purpose. This is also the reason why it’s so important that our educational settings enable positive mental health, rather than causing unmanageable levels of stress and anxiety in our young people at a crucial time of rapid cognitive/emotional development when health-related behaviours that can be carried into adulthood are formed. As an example of one of the broken components in the system, over half of university students say that financial worries from unprecedented fees and loans cause them to struggle with their mental health. We feel the reality of the mental health crisis acutely in Higher Education. The transfer of care model is completely unfit for purpose for those coming to university with pre-existing conditions, and young people often find themselves passed from pillar to post (a “hot potato”) in an overwhelming new environment. 

Over the past 10 years the proportion of students disclosing a mental health condition to their institution has increased five-fold, demand for counselling has doubled, and the clinical risk profiles of students seeking support are increasing in severity and complexity. Universities have struggled to keep pace with the demand, drop-out rates have increased, and many are yet to truly embody the holistic “whole-university approach” for mentally healthy institutions that’s recommended by sector leaders like Universities UK and the Office for Students. Luckily, we now have the Universities Mental Health Charter from Student Minds, an evidence-based framework to guide the sector towards best practice. I hope institutions across the U.K. commit to the Charter award scheme and start making real progress in student support. It can feel incredibly helpless to face this situation as an individual. Clearly, we need large-scale and systemic change from our government, fast, including a massive shift of funding and resourcing into mental health and welfare services, and that’s a huge battle to fight on your own. If you are a student, I want to encourage you to take any action you can to lobby our out of touch politicians to pay attention to the critical reality of the situation. Get involved with Student Minds and their LEADers programme or other amazing charities like Young Minds, write to your MP, or check out Youth Access’ Make Our Rights Reality ‘Our Minds Our Future’ campaign. I’ve signed up for rights advocate training on the 29th March in Leeds with the Youth Access campaign, and it’s all about that fight for mental health to be treated as a human right — find out more about how you can join here, but if you’re looking for something a little lower-energy, sign their petition here.

I'm the current Welfare Officer for Leeds University Union, working on mental health, period poverty and drug harm reduction, and I sit on the Student Advisory Committee for Student Minds.

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