Mental health awareness week: raising awareness is critical but only as a stepping stone to raising us all up

My daughter is seven and already understands the importance of talking about her feelings, getting things out of her head (especially if they are “all jumbled up” - her own lovely expression) and uses words like therapy, mindfulness and mental health with confidence and positivity. It is only one data point but it is evidence that we are, at least in some schools, winning the awareness war with the next generation. 

This familiarity with mental health and what it means if you are feeling worried, scared, sad or confused needs to extend into every classroom, college and campus around the country - and it needs to be the start, not the end, of our conversations. 

I am often reminded, especially for those of us who live and breathe mental health - whether viewed through our own mental health, the health of those close to us, or through our jobs and volunteering - that it is never a bad thing to be raising awareness and trying to reduce the stigma of talking about how we feel. For some people, having that first conversation, hearing that first story from someone they can relate to who is struggling, can change their lives. But I worry. No surprise there with my long history of depression and anxiety - a little mental health joke there for you! I worry because I fear that awareness raising is too often seen as the end point - the destination - and not the start of the journey. I worry that for some, awareness raising equals 'job done' when in reality it is only just 'job started'. 

It is vital - life saving at times - that we have more conversations about our mental health and that everywhere from schools to care homes we are raising awareness about how we feel and normalising the process of facing into our most difficult, sad and distressing feelings. But awareness needs to be a stepping stone to change and not the change itself. We need to build on the progress we have made across society in reducing the stigma of speaking up about our mental health - which I know is patchy and remains a massively unfinished task, especially in many workplaces and communities - and provide each other with options to make changes that will improve our lives. 

There are smarter people than me who are working on developing this menu of options and actions to help us move from awareness raising to change making and are campaigning to get those in power - in government, health services, workplaces and elsewhere - to help make it happen. But it’s not rocket science. The more we encourage people to talk about how they feel, the more we need to be ready to respond when the talking starts. We need not just to listen - although listen we really need to - but we need to be able to support the talkers with actions. Not with platitudes, but with professional support and workplace and learning cultures that can help people make a difference in their lives. 

For what it’s worth here is my starter for ten on the sort of things we need on our mental health menu:

• We need to introduce six month mental health check-ups for everyone on the NHS - like going for your regular dentist appointment. These check-ups can act as an early warning when things are starting to go wrong and for others can provide folk with the tools and ideas that can help them stay proactively well all year round - the mental health equivalent of flossing and brushing our teeth. 
• There needs to be fully-trained counsellor(s)/therapist(s) in every school and every sixth form and FE college
• Universities need to be ranked in a league table on the ratio of students to mental health/wellbeing support staff and on the time it takes to get an appointment to see a specialist on campus, the recovery rates from sickness due to mental health issues and their spending levels per student on health support services. We also need them to publish the reasons - the real reasons - why 10%+ of students drop out each year - putting some real data in the public domain to show much much of this is driven by mental health issues. Spoiler alert: it's loads. You get what you measure and I know from my time in higher education that everyone complains about league tables but that they do focus minds and push issues onto the agenda.  
• Employers should have a legal duty - like the public duty enshrined in the Equality Act - to provide every employee with access to support for their mental health and wellbeing, including everything from healthy physical workplaces to counselling and support, on site during the working day. Not a passive, do no harm duty - although that would be a good start - but an active requirement on employers to promote health and wellbeing at work.
• We need a huge shift in workplace cultures, including how we use over-use emails and meetings to put people under unbearable pressure, so that we stop seeing employees as resources and cogs in a wheel and to see them as people with lives outside of work and needs - ensuring they can make choices about when and where they work and making flexible working the rule and not the exception. 

There are of course more fundamental changes that are needed across society to ensure that everyone has meaningful work, a home, enough money to live on and access to equal treatment under the law and fairness from the authorities, but that is for an other post.

This all costs money - a lot of money - but the costs of not spending it in lost lives, lost opportunities, lost people and lost days to sickness and despair far exceeds the investment we need. It is surely the true measure of a society is how we treat those in need, not just those in power; how we level up our opportunities to have good levels of health, not just good levels of wealth.  

In his inspiring and ultimately tragic run for the presidency in 1968, Robert Kennedy reflected on the misplaced emphasis there was in the US on measuring the wrong things, with too much focus on wealth and GDP and not on health, culture and nourishment of our the souls: “.....it (GDP) measures everything in short, except that which makes life worthwhile.”

We need to enable people who have taken the often incredibly difficult and brave decision to start the conversation about their mental health to then have the next few steps on the journey open to them. They need options for what happens after they’ve hit awareness. They need to be able to move forward. To take control.

As I have written many, many times before, I believe passionately that our mental health is about the choices we make. We cannot choose to be happy or sad, whether or not we are depressed, but we can choose how we respond when things go wrong for us. We are in control of what we do when life throws stuff at us, even if it throws the most heartbreaking, soul-destroying things our way. 

In a week in which politics and elections have been front and centre, I wish I had a pound for every time I've heard the phrase 'levelling up'. It is a shibboleth of modern British political discourse for those who wish to be seen to be in touch with the various shades of electoral walls. Like so much in politics it is a convenient slogan, designed as a shorthand to convey virtue. But true levelling up isn't just about economic measures but about what it means to live in a fair and civilised society. That starts and ends with good health - especially good mental health.

If we are really serious about mental health and wellbeing we should use this year's mental health awareness week to map out the road ahead that has only just started when the conversations begin - and start to pay for it.

I see your awareness raising and I raise it to action. To investment. To change. To improvements. To choices. To a happier, better life available for all. Raising us all up. Every one of us. Every day.