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Are we oversimplifying our conversation about self-care and mental health?

Updated: Mar 8, 2021

First published by The Association for Young People's Health

I have a rule when it comes to twitter. Ten minutes maximum, only on Mondays and Thursdays. The days coincide with the days I work at the Association for Young People’s Health (AYPH). Since joining the charity, I’ve learnt that Twitter is useful when keeping up with the NHS folk doing exciting work in the world of adolescent health. The 10 minutes maximum is the length of time I can spend on that social media platform before it starts changing my mood. Any longer and I fall down a digital rabbit hole of gloom, a rabbit hole of bigoted old tree roots and uninformed misogynistic spider webs. One minute too long and I have condemned my day to feeling bleak and despondent. Sticking to 10 minutes, twice a week, is one way I sustain good mental health.

During my 10 min Twitter-gorge last Thursday, a promo video popped up that featured three people (one being the effortlessly cool Gillian Anderson). They were talking about how to manage mental health. “Write things down, garden and dance,” was their advice. The video is to promote the NHS’s Every Mind Matters website, where a person can take an online questionnaire and, based on the answers, get a mental health self-care plan. I took it and the advice was: get the couch to 5k app (an app based training plan to get the listener to run 5 kilometres), focus on quality time with friends and relax my mind and muscles. All these suggestions come with signposting to videos and links. ‘What a great resource’ I thought, but while that thought popped into my head, I couldn’t ignore a strange feeling in my chest, a cynical eyebrow twitched; something wasn’t sitting right. This wasn’t a new feeling either, I had felt it last year at a conference. The conference theme was Student Mental Health. I saw similar advice, with research backing it up: “10 minutes of mindfulness a day helps students cope with anxiety and stress” one study says.

Mindfulness, running, writing, even dancing, can this really be the answer to managing mental health? ‘There is A MENTAL HEALTH CRISIS,’ we hear, and with headlines about male suicide rates, abuse scandals, serious youth violence, students under obscene pressure and rising inequalities; could a spot of dancing round the marrow patch on your Nan’s allotment really be the answer?

Outside of AYPH, I work with survivors of violent and / or sexual trauma. I run therapeutically informed support groups, give talks, even have my own website that disseminates free to download trauma-informed resources and comics. On top of this I’m a producer and presenter on a podcast dedicated to investigating life after trauma. Would I be out of a job if all those people I work with simply wrote more stuff down? I mean, it’s a lovely thought isn’t it? But this hasn’t happened. Why? Because the mental health we are given top tips and advice on how to manage is not the same as the mental health we talk about when we talk about suicide, or abuse, or long term intensive psychiatric interventions. I think this difference is at the heart of my strange feeling and cynical eyebrow. Poor mental health is complex, can be ugly and washed in shame. We, as a society, do not deal well with these things. If Self Help books and TedTalks could fix this, there wouldn’t be so many of them.

I want to be clear: I am not attacking day to day coping strategies. If (and when) a client comes to me saying gardening/writing/mindfulness/dancing has helped them, I embrace and celebrate this wholeheartedly. I do however, want to say that if we are serious about eliminating the mental health crisis we need a distinction between managing mental health with regular activities and tools, and profound, clinical interventions for long term psychological pain that can lead to suicide. I’d like to broaden the conversation around mental health to include the shameful, difficult bits too. Let’s acknowledge that managing poor mental health isn’t always effortlessly cool – I hope (and think) Gillian Anderson would agree – let's realise that a conversation about poor mental health is also a conversation about homelessness and abuse and substances and access to the benefit system and the social determinants of health and intergenerational trauma and ableism vs isolation and education and privilege.

Turning off Twitter and writing down feelings may be enough for some, but for others it can be a small drop in the ‘self care plan’ ocean. Some may feel that these simplistic coping strategies are impossible to commit to, leading to a further sense of shame or guilt, rather than realising they’re the wrong tool for the job.

Preserving or improving mental health is a multi-faceted challenge. It is changeable and ever evolving. I am glad there is investment going into self-care routines, but I’d like that to go further and see the vast spectrum of mental health struggles and management taken into account and represented. Mental Health First Aid Training is a great start for organisations and HR departments. Taking the time to be aware of mental health services in your area and signposting that to friends, employees and family members is another. On an individual level, it’s useful to realise that managing mental health is not a homogenous experience. With empathy, we can make enough space for everyone to ask for help, manage in as many different ways as they need and hopefully, thrive.

Need help? Call the Samaritans: 116 123

Twitter: @SachsFisher

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