Two weeks ago (yes, it is June, yes, time is exhausting) was Mental Health Awareness Week. The theme of the week was kindness, designed to tie the numerous acts of kindness and flourishing communities that have emerged during the Covid-19 pandemic into the broader idea that kindness can enhance the mental health of individuals and communities alike.
There is significant scientific evidence that being kind and receiving kindness can be beneficial for our mental health. Volunteering online, checking in with friends and families, dropping some hygienically-baked cake off for a neighbour – all these activities can boost your self-esteem, foster a sense of connection and create a sense of purpose during this mad time. The kindness theme is also designed to emphasise the importance of being kind to yourself by taking a break from social media, dancing around the kitchen or taking a long bubble bath. ‘Now is the time’, the Mental Health Foundation website reads, ‘to re-imagine a kinder society that better protects our mental health’.
It is a lovely idea. ‘Awareness’ and ‘kindness’ are not terms that should be dismissed – my own recovery from anorexia and depression owes much to a growing awareness of the deeper roots of eating disorders, to the kindness of others and to my own attempts to practice self-care. It owes more, however, to my therapy sessions, my dietician, my parents’ ability to send me to a private clinic while I waited three months for an NHS counsellor to become available. It owes more to my daily dose of anti-depressants than it does to a boogie in my bedroom or flowers from a friend. It owes more, in short, to money.
There are two problems regarding the glorification of ‘awareness’ and ‘kindness’ as mental health treatments. The first is a gap in understanding when it comes to what these terms mean, and the second is that both are futile without adequate funding.
In popular discourse, mental health awareness means a chat. It means knowing that at any one time, 1 in 4 people are suffering from a mental health condition, knowing that mental health is something we all have, knowing that it should not be a source of shame. For those suffering acute mental health problems, awareness means something else. I can only speak from my own experience, but perhaps it would be helpful to outline what awareness means to me.
Every morning, I wake up and consider not taking my medication. I take it. Every meal, I consider not eating enough, or taking a secretive trip to the toilet afterwards in order to purge. I eat enough, and I do not purge. Every time I eat, I calculate the calories I have consumed – and every time I exercise, I calculate the calories I have burned. Every minute of every day, I am aware that my brain is not well, that it has thoughts that seem entirely separate from myself. I am always aware of my anorexia and depression. And I am always aware they may never leave me.
I face a similar disconnect when it comes to how kindness is understood in relation to mental health. The Mental Health Foundation website highlights ‘doing something you enjoy’ or ‘doing something for a good cause’ as ways to practice kindness towards yourself and others. These are, of course, acts of kindness. But when it comes to helping someone going through a mental health crisis, sending them some chocolate or getting them to volunteer should be viewed more as lovely bonuses rather than foundational acts of kindness. When I was ill, self-care involved valuing myself enough to brush my teeth. The acts of kindness I remember are my mum sitting with me while I spent 30 minutes eating a banana, or my counsellor kindly but firmly telling me I was facing hospital admission if I continued to exercise. They were not well meaning gestures – they were critical to my survival and recovery.
The second problem is that no amount of ‘awareness’ and ‘kindness’ is equivalent to sufficient funding. Fears that lockdown will trigger a mental health crisis are well documented, but our obsession with the consequences of Covid-19 risks ignoring that even without a pandemic, NHS mental health services are in dire need of additional funding and support. In December last year, the BBC found that while nine out of ten patients have their first appointment within six weeks of being referred to NHS mental health services, that gap between appointments is growing, with one in six patients waiting over ninety days between their first and second appointment. Schools are increasingly likely to bring in private counsellors to support children who cannot access NHS services, and the scattergun approach to funding has created a postcode lottery when it comes to surviving a mental health crisis.
We have become so aware that everybody has mental health that we have forgotten that some people have serious mental ill health. In general, talking to a friend is a wonderful way to support your mental health. In the midst of an episode of psychosis, anti-psychotics and paid, professional treatment are critical. In general, playing some happy music and baking a cake is a lovely form of self-care. In the middle of a bulimic binge-purge cycle, cognitive behavioural therapy and nutritional guidance are crucial.
Absolutely, bake that cake. Buy those flowers for your mum, socially distance with a smile. Be kind, be aware. Be aware that these things are not treatments, they are not cures. Be aware that the only way out of our mental health crisis is adequate funding, and know that the negative consequences of austerity are still being felt by those in need of mental health support. Be aware that kindness is not, and never will be, enough.