It was a story of a young man who has dropped out of university because he can’t cope with the pressure of studying during a pandemic, it was hearing that two girls I know couldn’t see their dad on Father’s Day because he’s having another breakdown, it was the news that a mother of three kids who lived around the corner from me had taken her own life… Today is the day I have to say, enough is enough. We need to talk about mental health. But we need to talk about it differently because clearly, our current strategy isn’t working.
It’s true that public attitudes towards mental health are improving and, with thanks to the great work of advocacy groups, there is increasing commitment from workplaces, medical systems, schools and within governments to change. But for all our medical and technological breakthroughs, at a time when every country in the world is facing and failing to tackle a host of mental health concerns, our conventional approach is still absurdly limited. “People can talk about it, but that talk has to go somewhere. It has to turn into something that actually makes a difference to people’s lives and mental health and wellbeing,” said Professor Willem Kuyken, who’s the Director of the University of Oxford Mindfulness Centre and a leading depression researcher.
What really highlighted our shortcomings in mental health treatment and prevention for me, was looking into the current global data on the availability of qualified psychiatrists and psychologists. I did some basic back of the envelope maths and realised that even if there were such a thing as “preventative psychology” (which there isn’t), there is a chronic shortage of mental health professionals. On average, if all the available qualified psychiatrists and psychologists in the world worked around the clock 24/7, they’d only be able to spend one hour with each of us once every five years. In Australia, where I live, which is a country considered to be at the forefront of mental health care innovation, it’s marginally better because we could all see someone once every six months.
Our current approach to mental wellbeing, which predominantly relies on one-on-one therapy and medication, and treats people only when they’re unwell, is fundamentally flawed. “It’s like we’re waiting for the cancer to be at stage three or four before intervening,” Willem said.
I got in touch with Willem when I was in the midst of my latest journalism project, which involved a 30 000 kilometre journey around the world in search for the evidence-backed, mental wellbeing equivalent of a 30-minute workout or eating a daily serving of five fruit and vegetables. (You can hear my extended interview with Willem here).
I was looking for something that I could do for myself, and something that I could teach my kids to protect, nurture and nourish our minds. While the role of things such as diet, sleep, exercise and social support are recommended for good mental health, I needed something more concrete; a kind of psychological fitness training.
Willem is the lead author of a paper published in The Lancet which demonstrated that an eight-week program called Mindfulness Based Cognitive Therapy (MBCT), which is delivered in groups and involves daily homework for participants, was equal to medication for preventing recurrent depression. At a time when approximately 300 million people have depression and every 40 seconds, someone, somewhere dies by suicide, this is no small thing. Willem is now undertaking a study investigating if mindfulness training in teenage years can prevent depression later in life.
As encouraging as it is, research of this kind, which has the potential to transform lives, is actually rare and woefully underfunded.
Mental health research has long been the poor cousin of medical science. In the UK for example where Willem is based, they spend 25 times more on per capita cancer research than on per capita mental health research. And it’s not just governments that have a blind spot for mental health research. Here in Australia, the private and corporate sectors donate 11 times more to cancer research than to mental health research.
a total of about $130 million to “improve mental health care and reduce suicide rates.” Putting aside the fact that, by way of comparison, $400 million dollars has been granted to foreign film and TV production companies to “incentivise the international screen production activity,” during the same period, from what I can tell about how the mental health funding will be spent, the bulk of the $130 million has been allocated to mental health hotlines, apps, support services and outreach programs, which are all worthy causes, but only about 3.6% is for research.
And research matters. The uncomfortable truth about our current approach to mental health is that we still don’t know enough about what really works. Despite there being a number of evidence-based treatment options for addiction for example, relapse rates are as high as 60 percent in the year following treatment. There’s a 50 percent chance that if you’ve had depression once, you will get it again, and an 80 percent chance that if you’ve had depression twice, you will get it a third time. “If you think about depression as a recurrent problem, that means it’s a one-billion person problem; a billion people will suffer depression at some point in their lifetime,” Willem explained.
If you’ve seen the film or read the book that resulted from my latest self-experiment and deep-dive, you’ll know that like Willem, I did conclude that high-quality mindfulness programs, which can be delivered in a group format, practiced regularly at home, and work and an adjunct to whatever else is available, hold promise for the future.
But I also know from my own life that behind the research results, and the mental health facts and statistics lies a painful lived experience and that the wounds of mental illness run deep, not just for those who are suffering but for those around them. The young man who had a bright future ahead of him but who was never taught the how of living with daily uncertainty and fear, the two sisters who desperately missed their Dad on father’s day, and the three children who’s mother will not be there to see them graduate, get married and have families of their own.
If we want to turn the global mental health pandemic around, we need a radical change in the current paradigm. It's to time to invest meaningfully in research, to develop evidence-based mental illness prevention programs that are widely available and easily accessible, and to find new models of care that factor in the whole shebang of biological, social, cultural and spiritual dimensions that make us well beings.