Mental health is not an easy topic to discuss. It’s one that, not that long ago, was never brought up in conversations, was taboo and often seen as a sign of weakness. Today, talking about your mental health (or someone else’s) is slowly becoming more common, with some countries and cultures more open-minded than others. Yet, when it comes to mental health problems, especially for teenagers, we still have to fight for more—more discussions and more help to reduce the stigma that surrounds it.
This is what four students from Oregon, U.S. worked towards by implementing a new law that allows students to take ‘mental health days’ off school, just as they would sick days. Talking to NBC News about this concept, experts said it is “one of the first of its kind in the U.S.”, something that is both worrying for the present and inspiring for the future. How have we not yet tackled mental health as a global topic that affects about 1 in 10 children and young people? And where does this stigma come from? Screen Shot spoke to Paris-based child and adolescent psychiatrist Dr Hélène Strauss for some answers.
“Indeed, mental health problems, schizophrenia in particular, scare people away and convey this image of a crazy person that hears voices. In the U.S., with the healthcare system they have, Americans with health problems often end up homeless,” said Dr Strauss. According to the Mental Health Foundation, 70 percent of children and young people who experience a mental health problem have not had appropriate interventions at a sufficiently early age. Mental health problems include depression, anxiety, self-harm, generalised anxiety disorder (GAD), post-traumatic stress disorder (PTSD), and eating disorder. These are mental health problems that commonly occur in children, often as a direct response to what is happening in their lives.
“In France, teenagers that need mental health services can gain a medical certificate. Medical confidentiality is respected and their note never specifies a diagnostic. With the children’s agreement, the psychiatrist can then work with teachers and the headmaster in all discretion. Adolescence is a sensitive period and, sometimes, specific symptoms have to be taken care of urgently. Being able to miss school in order to seek treatment can be indispensable,” adds Dr Strauss.
A recent study by YouGov showed that 30 percent of millennials in the U.S. say they always or often feel lonely, a higher percentage than baby boomers, at only 15 percent. While this specific study didn’t look at the possible link between mental health and social media, earlier studies point to these platforms and the internet more generally as influences. Talking about social media, Dr Strauss says, “Social media made bullying and harassing easier. This can strongly affect a child and teenagers’ fragile mental health and lead to anxiety, sleep disorders, and suicide attempts.”
One of the four students who helped push the mental health bill, 18-year-old Haily Hardcastle, said she’s received some opposition from parents who said the legislation wasn’t necessary, as students could already take mental health days off by pretending to be sick. Others worried about students using this law as an excuse to miss more school, bringing down the already low attendance rates.
This mentality is exactly what pushes teenagers to lie about their mental health problems, it’s what keeps the stigma surrounding it alive. It is urgent for parents to realise that opening up this discussion is the only way to tackle mental health, and that calling kids ‘over-sensitive’ or ‘coddled’ does more damage than them missing a day of school because they feel physically or mentally ill.
Dr Hélène Strauss counter argues that even though this law is a big step forward in the discussion surrounding mental health, it is also a double-edged sword that clearly goes against the concept of medical confidentiality. Even a short stay in a psychiatric institution affects someone’s life—it shows on your medical record, influences your bank credits, and even your job opportunities. Dr Strauss’ worry is that this bill would be used against students in the future to almost ‘penalise’ them, instead of working in their favour. This point makes sense, considering how governments and lawmakers can sometimes manipulate people; yet it’s also one I choose to ignore for the moment, worried I might start wearing a tin foil hat or worse, storm Area 51.
What can we do in the meantime? Act on the public health domain first, and “Promote access to psychological care for children and teenagers, train teaching staff so that they can provide kids in need with guidance, implement school psychologists and prevention campaigns in schools” as Strauss stresses. Let’s make big changes with small steps.
“Taking care of yourself is always the first step.” Fahad Al Saud tells me one rainy afternoon. I’ve come to visit the minds behind Tomo, a new app that uses behavioural activation to help sufferers of mental health through their daily activities, both mundane and meaningful. CEO Gus Booth-Clibborn and Chief Product Officer Fahad, who is also a UCL trained neuro-biologist and a self-taught coder welcome me at their office – it’s inside one of those classic London alleys that after living in the city for some time, I still rarely come across.
Tomo uses intricate algorithms to understand individual user’s symptoms and prompt them to do the daily activities that help maintain a healthy lifestyle. From eating properly, to keeping up with their hobbies and passions, with a focus on socialising as an important part of the user’s daily activities. An anonymous image sharing ‘gallery’ then allows peers to share photographs of their daily achievements in support of one another. Essentially, it’s a way of giving each other a pat on the back for the everyday achievements – an aspect that both Gus and Fahad believe is crucial for turning new behaviours into life-long habits.
“Not sleeping correctly, not eating right, avoiding your community – that’s a lot of where mental health and depression manifests in the day to day. Having a place where people can share and celebrate those little struggles, and making sure that it’s recognised as an important part within the community is fundamental.” Says Fahad. During his years in academia, Fahad himself suffered spells of depression, “incidences of mental health are quite high among the academic population, especially when you go into the PhD area” he tells me. During which time he started looking to behavioural activation (BA), a form of therapy – and in many ways – a set of tools and skill sets that come from cognitive behavioural therapy. The principle behind BA isn’t merely understanding your own thought patterns, but also understanding your own behavioural patterns: your helpful and unhelpful habits, how you deal with different challenges, and learning how to gradually change those to build a life that is resilient to whatever comes and goes – whatever your triggers may be.
In Britain alone, 16 million people are estimated to be suffering from mental health disorders. A near third of an entire nation’s population are living, every day, with the struggles that accompany the myriad symptoms of mental ill health. What’s more is that 30% of people suffering from depression continue their daily lives undiagnosed, and that in itself, is a symbol of a failed social awareness to mental health as well as a national health service that is underfunded and overwhelmingly exhausted.
Tomo, like many of the apps sprouting up in recent years, works to relieve the strain from the NHS while helping people understand that a normal diagnosis may not encapsulate the full range of mental illnesses they might be experiencing. The app also allows users to get prior warning when they’re about to get low, a fundamental aspect of working with behavioural monitoring. Many people may be suffering from various symptoms of depression, at different intensities, and that is still worthy of support. Yet, under the current mental health scheme many such ‘minor’ cases become brushed off until developed to more severity – a method that is both counterproductive (financially) and damaging to individuals, communities and the society.
“It’s a rapidly evolving sector, which makes it a really exciting thing to be a part of. People are coming out of academia, out of the patient perspective like Tomo, maybe even out of health care, out of the NHS, and we’re all trying to find and to create a range of different tools that people can use for support in mental health.” Gus says. “We seek to do one thing well and that is to use distributed peer support to support behavioural change. We’re looking to create a community to help people do simple things that make them feel better.”
Both Fahad and Gus explain how the need for innovation in the field is so wide that there is a surprising collaborative spirit between the apps and inventors behind them. “We face a system where the people who are genuinely trying to help are so overloaded that companies like us can support them by doing things they simply aren’t able to do. By being in someone’s pocket all day in a way that no psychiatrist can.”
Both Fahad and Gus explain how the need for innovation in the field is so wide that there is a surprising collaborative spirit between the apps and inventors behind them. “We face a system where the people who are genuinely trying to help are so overloaded that companies like us can support them by doing things they simply aren’t able to do. By being in someone’s pocket all day in a way that no psychiatrist can.”
It seems that the most important aspect of Tomo is that users are getting the human recognition that celebrates all their little struggles. And also on the other side, as Fahad tells me, “that users are seeing that someone got out of bed – that’s a big deal – and it’s breaking down all of that stigma and helping people accept their own cycles: that there’s a range of different experiences and they’re all OK, and we can all get through them together.”
The biggest barriers about this field are not embedded in uprising competition, but the challenges that come with creating a new vessel for mental health support, a section of human wellbeing that has been ridden with stigma and silencing for centuries. Tackling mental health and urging the openness with which it needs to be treated is key for progress in the field. It’s about revamping how the current system works, how people access therapy and therapists; how people talk about it with their peers, friends and family.
As Fahad told me with a warm grin on his face, “you don’t need to be filling out worksheets when there’s tech that can do that for you.” It’s exactly when technology is carefully moulded together with ethics and compassion that its mechanism can release the burdens of the day to day. In the case of Tomo, this means that those suffering from mental health can focus on the most important part: working on recovery and understanding their personal triggers and patterns together, as a community.
