It is the leading killer in the UK for those aged between 18 and 24, with young men generally around 3 times as vulnerable as young women. That’s higher than accidental death in relation to alcohol or drugs, higher than stabbings or shootings, and higher than deaths from traffic accidents. Suicide can be linked to a number of mental health issues, including Schizophrenia, eating disorders, and anxiety disorders, and is of course in particular linked with depression.
Depression is the most common mental health issue in the UK and globally: around 1 in 10 people will experience depression in any one year. My view of depression is that it is a position past the “harmful” threshold on a spectrum of normal human sadness. I don’t really see it as an illness, as such. Some people are born more vulnerable genetically to it than others – i.e. their personal threshold to depression is lower than most – and people with depression certainly show biological differences (e.g. in terms of Serotonin levels) to those who are not depressed. However, it makes more sense to me as a normal reaction – with biological symptoms – to external stressors, including both constants such as lack of control and frustration linked to issues like money, and also specific emotionally damaging events such as bereavement or the end of a relationship.
The Guardian has reported today that the rate of suicide in students rose by 50% between 2007 and 2011, identifying that this has taken place in the context of huge fee rises and the slashing of mental health support services. More students are trying to access help for mental health issues, but the support that is there is considerably overstressed. Loss of counseling and other support services is alarming, but I think only part of the issue.
Over forty years ago anti-psychiatrists pointed to the dangers of pathologising depression and other mental illnesses, arguing that it creates a false impression of depression as an internal, individual fault in biology or thinking patterns, rather than an internalisation of an externally depressing society with wider structural sickness. Anti-psychiatrists today would point to the controversial evidence that standard anti-depressants, SSRIs, actually increase the risk of suicide in under 25s, and CBT (Cognitive Behavioural Therapy, the talking cure now most commonly used by the NHS) could also be seen to be limited, as it takes the default position that depression is an irrational thinking process which can be remedied through teaching the individual skills in examining and changing their thoughts, which rules out entirely any possibility that the high levels of depression in our society today are rational, normal responses to disabling economic and political conditions.
The imposition of huge fees, which will leave most with around £30K worth of debt, come as part of a political package which sees graduate job opportunities falling, rising costs of living, and as previously mentioned huge cuts to the services which support those who are suffering from mental health issues. If we want to stop these preventable deaths – other people’s kids, sisters and brothers, partners, friends – then we should of course be campaigning to protect these services, in the same way that we would campaign to protect food-banks if they were being slashed: they provide vital support to those who need them. However, just as food-banks treat the symptoms rather than the causes of poverty, mental health services are reactive rather than proactive in dealing with depression.
For a big impact on suicide levels in young people, we need to be really looking at how our social structures and the cultures of our institutions and workplaces disable and trigger those vulnerable to depression. It will take a bit more than the usual approach to mental health issues that organisations use, which range from the common box ticking exercises designed to fit some “this institution is good for mental health” criteria to focus groups with varying levels of impact. If we really want to protect young people from panic and doubts over their future security, if we want to protect them from feelings of inadequacy, crippling low self-esteem, worthlessness and frustration, if we want to provide a culture in which young people are valued, encouraged, and equipped with the skills and support to take on the challenges of life in a confident and fulfilled way, then really we need no less than a revolution in the way we understand mental health.
We need to start to think about what a mentally healthy society might look like. When we look at happiness in Psychology, we tend to be drawn to humanist principles – the need for fulfillment, for example, and for friendship. While these are often linked in a broad way to problems with the individualist, competitive nature of society, this tends to be treated as a politically neutral issue, with the odd allusion to an imagined past, and generally a focus on guiding the individual to trying to address these needs. We can do much better than that. We need to look at what it is about our society which is pathologically isolating, frustrating, and devaluing – and change it.