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Do you think we talk enough about mental health?

As students, we are a relatively liberal group, especially when it comes to conversation topics, and yet mental health appears to remain a taboo subject. With such a glaring and relevant issue, one has to ask, ‘why?’

Mental health is a subject Hannah Capocci, the current coordinator of Nightline, is often talking about. Hannah points out that people find talking about mental health difficult because the “taboos surrounding mental health issues have led to stereotyped opinions.” Indeed, individuals often comment that they would rather suffer in silence than risk being stereotyped.

While sufferers find talking about their problems difficult, Hannah reminds us that listening can also be hard. “When you know there is no easy way out of an individual’s problems, it can often be difficult to go on listening. It is hard to refrain from giving advice and easy to offer your own solution, but if you step back you should see that none of us have any right to tell someone else what to do with their life.”

If listening is hard, understanding is even harder. This is something Jenny, a recovering anorexic, knows well. She has just started university at Nottingham. Along with all the usual trials a first year student faces, she needs to think about how to manage her history of eating problems. Putting yourself in her shoes is not easy. “Anorexia,” Jenny explains, “has been a way of blocking out the bad things in life. By becoming thin, I thought I would be more popular. It is a feeling that starts as just a small niggle but before long takes over all your actions and decisions.” Though Jenny is clearly on her way to recovery, relapse is something she has to consider and she does not feel that she could easily discuss her past problems with new friends at university.

So, perhaps we have a resolved situation: Individuals with mental health problems generally find it easier not to talk about their difficulties and the rest of us are relatively happy to let the silence continue.

Jenny would be quick to point out the problem here. Sufferers need support. As she highlights: “with your family away, if you were really ill, I am not sure who you could turn to. I think that battling alone would be really hard, if not impossible.” Too often university students, attempting to manage mental health problems away from the support of their family and old friends, either find themselves slipping until their situation reaches a point that health care professionals will term critical, or are forced to drop out of university to return to the support of their families.

Facing such high costs of keeping problems secret, we might ask why individuals with mental health problems are not more open about the struggles they face. Anna attempts to explain why she has often chosen to keep quiet about her problems with depression. “Mental health is generally misunderstood and so sufferers often feel alone, isolated and outcast. When people have a physical illness, it is something tangible and far easier for people to see and understand. It is not like that with mental illness. Making yourself understood is difficult. I am tired of going through life constantly having to justify myself. People are fearful of what they do not understand and so I have to be careful about what I tell people. I am only honest about my problems if I feel sure that the individual I am talking to will not judge me or change the way they act around me because of what I have said.”

We would be amazed to know how many people, like Anna, run active lives whilst keeping quiet the problems troubling them. Earlier this year, James learnt that a friend of his had been hospitalised after a failed suicide attempt. James explains how shocked he was to learn about her problems. “She had been running a very active life at university, seemed happy and was literally the last person who you would have thought would be in that sort of trouble.”

It is clear that individuals facing mental health issues would rather keep their difficulties quiet because they fear a lack of understanding and being labelled by their problems. The silence surrounding mental health however means that many individuals struggling do not turn to others for necessary support. This silent struggle is painful; it is exhausting to maintain a pretence and a double life. The problems with this run deeper still and lack of communication allows the problems surrounding care for individuals with mental health problems to be all too frequently overlooked.

Take for instance the University Counselling service. Whilst it is fantastic that the university provides such a service, the length of the waiting list is depressing. Visiting the counsellors is not something people talk about, and yet if we did, students may be saddened to realise that individuals with acute problems at times have to wait upward of two months before their sessions. Rebecca explains what effect this had for her. “I have had problems with self-harm for a long time. At my worst, I was cutting myself many times a day. Though I have generally been doing okay, in the autumn term last year, I felt myself falling backwards. I went to visit the university counsellor, hoping that if I could speak to someone, I might be able to avoid turning back to self-harm. I had a very helpful initial session. This was such a relief. In the time however before I was able to start regular sessions, I started self-harming again. I left university early for the Christmas holidays, hoping the security of my family around me would avert a complete crisis. Back at university in January, I still had no news about starting sessions.”

While there are limitations in receiving the support of counselling, we might hope that individuals facing long term and more severe problems might find support in the medical profession. At a recent conference on eating disorders, I was reminded that the Nottingham Primary Care Trust is only able to support individuals with eating disorders when their condition becomes severe. This usually means that their BMI has fallen below 15 kg/m2.

In response to the lack of NHS care for individuals with eating disorders, a group of students are running a self-help group to support individuals struggling with eating disorders. Training with B-eat, they joined over 70 other such voluntary groups to provide peer-to-peer support. This offers a confidential setting for sufferers to speak openly about life with an eating disorder. The group is run so that individuals do not have to suffer in silence. This level of support however is not enough. More needs to be done to support individuals with mental health problems before they reach that severe stage of illness.

With eating disorders, the longer an individual’s duration of illness and the lower their BMI falls, the less likely they are to make a full recovery. Hope for recovery lies in beating the problem before the disorder fully develops. Knowing this, one should feel disgusted that more is not done by the National Health Service to support individuals before their illness becomes severe.

If we want the treatment of mental health to change, we have to start talking. It is time individuals with such problems were listened to and understood.

Nicola Byrom

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