The Problem with ‘Mental Health’!

In the media we often hear of a mental health crisis amongst young people and we are aware of long waiting times for many mental health services for children and young people. Many educators will have observed an increasing number of young people who seem to be experiencing difficulties in managing the challenges of everyday life. But what do we mean when we talk about ‘mental health problems’? We may be thinking of the emotional distress that we witness in the young people we know, an increasing  number of behaviours that challenge, school avoidance, or perhaps other changes in behaviour that we observe.  But is it helpful to frame these emotional and behavioural challenges as mental health problems?

Thinking of the challenges in terms of mental health can certainly have advantages. It can help us to have sympathy for the person who is struggling and to avoid blame. If the problem is one of mental health, then it is not the fault of the sufferer- they need help rather than judgement- and a diagnosis can open doors to support. On the other hand, a label of mental illness may lead to a sense of inevitability and a belief that there is nothing that can be done without the help of a mental health specialist, and this is often not the case. There are many things that can be done by supportive peers, adults and perhaps even the person who is struggling. 

One factor, which may increase resilience and mitigate difficulties such as low mood and anxiety and associated behaviours, is the way that we speak to ourselves and others. We can keep in mind that it is not the fault of the individual that they are struggling, whilst at the same time believing that with appropriate support they can learn to take responsibility for how they manage their struggles. Modelling this way of thinking in how we relate to ourselves and others can play an important role. Do we demonstrate gentleness and compassion towards ourselves and others in our everyday interactions? Some of us may find self-compassion the greater challenge, but if we can say lightly to young people, “This is hard/I made a mistake, it’s okay, and this is what I’m going to do about it”, we are modelling something helpful. Being seen to be perfectionistic or drive ourselves too hard is less helpful.

When we are ourselves under huge pressure to perform and feel criticised, it can be hard to hold onto our intention to nurture rather than pressurise and criticise ourselves and others. Systems that are punitive do not help to get the best out of us, and neither do systems where resources are over-stretched. Phrases like ‘helping the helper’ or ‘filling our own cup first’ may be cliches, but it is true to say that if we are going to do our best for young people, we need to make sure that those charged with their care are adequately resourced. In an educational setting, this could mean many things. Are the adults in schools sufficiently supported? Do pressures on their time mean that it is difficult for them to notice what is going on for students and talk to them about it? Do they receive training that enables them to identify emotional challenges in young people and feel confident about responding appropriately themselves and/or making referrals where needed?

In order to understand the emotional and behavioural responses of young people and adults, we need to consider the context. Some contextual factors occurring within the educational setting can be addressed, whilst other environmental factors, such as poverty and a lack of investment in community facilities for young people, may seem beyond our power to change. Nevertheless, they should be acknowledged.

While the label of ‘mental health’ can facilitate understanding and improve access to support, it also brings the risk of pathologising ‘normal’ and even healthy responses. For example, feeling ‘anxious’ before giving a presentation or sitting an exam may feel uncomfortable, but it is a useful response which can help us to focus and perform at our best. While higher levels of anxiety might inhibit good performance, if we always avoid anxiety-provoking situations we will not learn to manage them well. The line between what is ‘normal’ and what is ‘problematic’ is not always clear, but psychologists tend to consider that professional support may be needed where the level of distress is high and there is a significant impact on the individual’s daily living. We all have ‘good’ days and ‘bad’ days, but if distress is more prolonged and impactful then it may be time to seek help from an appropriately qualified child psychologist, psychotherapist or counsellor.

In conclusion, the label of ‘mental health’ may be helpful in reducing the blame the young person might otherwise experience from themselves or others, and it may help them access appropriate support. Less positively, it may pathologise ‘normal’ experiences, for example of anxiety and low mood, and inhibit us from doing what we can to address what is happening. It may also deflect attention away from systemic factors that need to be addressed, locating the problem within the individual rather than encouraging us to look at the wider issues impacting on them.