Mental health isn’t the problem—the system is: Natasha Devon on Sir Simon Wessely’s controversial comments
20 August 2024, 14:59 | Updated: 4 September 2024, 07:12
Sir Simon Wessely, who is a non-executive NHS England director and former president of the Royal College of Psychiatrists, caused some controversy yesterday when he claimed continued awareness-raising around mental health should cease because services are struggling to cope with demand.
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He went on to cite the fact that young people are far more likely than older generations to report poor mental health and to say “they were talking about loneliness, homesickness, exam stress, academic pressure, concerns about climate change, which we probably wouldn’t really classify as mental disorders”.
Whether or not we consider Wessely’s comments plausible depends on what he meant by them. I have long maintained that many of the contributory factors to children and young people’s mental distress are a reflection of the harsh environment in which they find themselves.
It is valid, I believe, to say that we are potentially medicating ourselves against injustice when our energies would be better spent trying to make society fairer and the future less bleak. After all, as Jiddu Krishnamurti once famously said ‘it is no measure of health to be well adjusted to a profoundly sick society’.
It may be that this is what Wessley meant. If, however, he is taking the more common view that younger generations are inventing mental health issues and simply need to have ‘more resilience’, then that is where we part company.
On point one – There is a famous graph which shows that, in around about 1905, rates of left handedness in children suddenly spiralled.
This is not, of course, because there were actually more left-handed children, but a reflection of the fact that, prior to this, it was not acknowledged that someone could be left-handed.
What is perhaps more of interest for our purposes is that, right up until the 1960s, rates of left-handedness in children continued to increase steadily.
In the early 60s, they levelled out at about 10%, which is what we now understand the percentage of left-handed people to be, as part of natural human variation.
Why the continued rise over decades? Well, when you spend centuries demonising something (as occurred with left-handedness since it was associated with the demonic), then it creates stigma.
Stigma takes a long time to eradicate and such it is with mental health.
It may very well be that a high proportion of human beings have always experienced mental illness and it is merely that we are still in a period of stigma-eradication. At some point in the future it may level out at a consistent percentage (see also: neurodivergence and transgender people).
Having said that, Gen Z and Gen A are facing a particular cocktail of circumstances which would understandably make their mental health outcomes worse.
Children and Adolescent Mental Health Services have cut to the bone via 14 years of austerity measures, as have educational psychology and other vital forms of support which help children flourish.
Class sizes are spiralling, and overworked teachers are struggling to give young people the individual attention they need. Subjects with proven therapeutic value - like music, art, drama and sports – have been radically reduced in state schools under Gove’s sweeping education reforms.
Many communities have lost vital hubs such as sports centres and libraries. Parents and carers have to work longer hours to make ends meet, leaving them unable to spend as much quality time with their children.
Older teens face a choice between a terrifyingly competitive employment market or taking on record amounts of debt to go to university. Racism and misogyny are rife, the planet is dying and we may very well be on the brink of WW3.
In other words, many children are growing up in an environment where not only is everything scarier and more pressured, but the things which would allow them to cope have been taken from them.
In that context, it doesn’t matter if the reasons they give for their overwhelming anxiety or depression seem mundane.
If they are struggling to function, they require support.
And however convenient it might be for an overburdened NHS to attempt to do so, I’m afraid there is no getting away from that fact.
